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Experience With the Use of Free Fasciocutaneous Flap in Through-and-Through Cheek-Buccal Defect Reconstruction

Surgical Outcome and Quality of Life Analysis

Lin, Chih-Hsun MD; Chiu, Yen-Hao MD; Perng, Cherng-Kang MD, PhD; Liao, Wen-Chieh MD; Ma, Hsu MD, PhD

doi: 10.1097/SAP.0000000000000692
Clinical Papers

Background Through-and-through cheek-buccal soft tissue defects usually require fasciocutaneous flaps for reconstruction. However, no ideal flap has been established for reconstruction.

Methods A retrospective chart review of head and neck reconstruction performed at Taipei Veterans General Hospital between 2003 and 2012 was conducted. Surgical outcomes and quality-of-life assessments between different fasciocutaneous flaps were collected and compared.

Results Eighty-five patients received a free anterolateral thigh flap, and 25 patients received a free forearm flap. The flap success rates were 96.4% for the free anterolateral thigh flap and 96% for the free forearm flap. Appearance, swallowing, and speech were less satisfactory in long-term follow-up; and recurrent tumor, flap size (>100 cm2), oral commissure involvement, and long hospital stay (>40 days) were associated with unsatisfactory quality of life.

Conclusions Free fasciocutaneous flap can result in acceptable success rates, but patient satisfaction with appearing, swallowing, and speech function was relatively low after reconstruction. Tumor status (primary or recurrent), flap size, oral commissure involvement, and length of hospital stay are the main factors that affect quality of life.

From the *Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; and †National Yang-Ming University, Taipei, Taiwan.

Received October 12, 2015, and accepted for publication, after revision October 27, 2015.

Conflicts of interest and sources of funding: none declared.

Reprints: Hsu Ma, MD, PhD, Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; 19 F, No. 201, Sec. 2, Linong Street, Beitou District, Taipei City 112, Taiwan (Republic of China); E-mail:

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