手前腕遊離皮弁（RFFF）による口腔内再建への応用 - 後ろ向き研究

The radial forearm free flap (RFFF) is an established technique for the reconstruction of intraoral defects following oncological resection. The objective of this study was to evaluate the functional, aesthetic and complication-related outcomes of the RFFF in immediate microvascular reconstruction of intraoral defects.

A retrospective, observational and descriptive study was conducted based on the clinical records of 15 patients who underwent resection and immediate reconstruction with a RFFF at Hospital de Clínicas "José de San Martín" between May 2019 and June 2024. Post-operative oral function was assessed using the functional oral intake scale for swallowing, the speech intelligibility rating for speech and the modified Vancouver Scar Scale for aesthetic outcomes. Complications were classified according to the Clavien-Dindo system adapted for reconstructive microsurgery. Descriptive and inferential statistical analyses were performed, with significance set at P < 0.05.

The mean age was 62.8 years; 60% were female. The most frequent diagnosis was oral cavity squamous cell carcinoma (80%). Flap survival was 100%. Swallowing function was adequate in 86.7% of cases, speech in 73.3% and aesthetic outcome in 80%. The overall complication rate was 20.0%, with only one case requiring microsurgical reintervention. No statistically significant association was found between the occurrence of complications and functional or aesthetic outcomes.

The RFFF proved to be a safe and effective technique for immediate reconstruction of intraoral defects, offering high survival rates and satisfactory functional and aesthetic outcomes.