[Functional and morphologic results of pedicled and microvascular anastomosis in tissue transfer]

From 1982 to 1992, large intraoral and pharyngeal soft-tissue defects were reconstructed using myocutaneous island flaps in 95 patients, free jejunal interpositions in 10 patients and forearm flaps in 18 patients at the Magdeburg School of Medicine, Department and Clinic of Otorhinolaryngology. Sixty-five patients were followed up after various time periods in order to assess the functional results. Investigation and evaluation of the individual patients' resultant quality of life were based on a specifically prepared examination questionnaire. In particular, the evaluation included: the mouth opening gap, motility of the tongue, sufficient masticatory area, adequate provision to fit artificial teeth, malocclusion, the extent of mandibular deviation, assessment of the swallowing act, articulation disturbances, paraesthesia, function accessory nerve, atrophy of the trapezius muscle, motility of the cervical spine, flexibility in the shoulder girdle, as well as subjective information obtained from the patients (pain, feeling of dryness, increased salivation, occupational rehabilitation, organisation of leisure time). In 45 patients, biopsy material from the transferred tissue was examined at varied time intervals after primary therapy.

The functional results obtained for the myocutaneous island flaps, the forearm flap and the free jejunal interposition were satisfactory, and only minor differences were noted. From the morphological point of view, all the three types of tissue transfer were found to have adapted adequately to the recipient site.