Subjective morbidity following radial free flap reconstruction in head and neck tumour patients

J Laryngol Otol. 2019 Mar;133(3):230-235. doi: 10.1017/S0022215119000197. Epub 2019 Feb 28.

Abstract

Objective: Evaluation of post-operative donor site disability remains unaddressed in radial forearm free flap cases. This study aimed to assess donor site dysfunction following radial forearm free flap harvest using validated general, disease-specific and site-specific disability questionnaires.

Methods: In this retrospective case series of 24 patients at a tertiary academic medical centre, patients were assessed using the Short Form 36 Health Survey, Short Musculoskeletal Function Assessment questionnaire, and Disabilities of the Arm, Shoulder and Hand questionnaire. One-sample z-tests were performed, comparing means of the cohort to controls.

Results: Compared to population controls, the cohort had higher mean scores for the Disabilities of the Arm, Shoulder and Hand questionnaire (18.22 vs 10.1, p < 0.01), and Short Musculoskeletal Function Assessment questionnaire bothersome index (21.44 vs 13.77, p = 0.04), and a lower mean score for the Short Form 36 Health Survey physical component (38.88 vs 50, p < 0.01), indicating a greater disability for the cohort compared to controls.

Conclusion: Radial forearm free flap harvest causes significant long-term donor site disability in head and neck tumour patients. The Disabilities of the Arm, Shoulder and Hand questionnaire is a concise tool for measuring this dysfunction.

Keywords: Forearm; Free Tissue Flaps; Head and Neck Neoplasms; Quality of Life; Reconstructive Surgical Procedure; Surveys and Questionnaires; Upper Extremity.

MeSH terms

  • Adult
  • Aged
  • Disability Evaluation
  • Female
  • Forearm / surgery*
  • Free Tissue Flaps / adverse effects*
  • Free Tissue Flaps / surgery
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Retrospective Studies
  • Surveys and Questionnaires