Abstract:

Objective To investigate the value of free forearm flap implantation during postoperative functional reconstruction after tongue carcinoma resection. Methods Ten patients with tongue carcinoma underwent free forearm flap implantation after primary tumor resection and neck dissection. During implantation， anastomosis was created between the external maxillary and radial arteries， followed by anastomosis between the external jugular and cephalic veins. In two patients， anastomosis was also performed between the lateral antebrachial cutaneous nerve and the proximal stump of the lingual nerve. Flap sensitivity was analyzed in a subset of patients at 6，9，and 12 months after implantation. Results In all patients，the flap survived without infection or fistula formation. Flap sensitivity was measured postoperatively in six of 10 patients， including one of the two who underwent lateral antebrachial cutaneous nerve implantation. The patient who received lateral antebrachial cutaneous nerve implantation recovered light tactile and heat/cold responses， as well as 2-point discrimination （static） ability，whereas the other patients did not. Conclusion Free forearm flap implantation can effectively repair defects after tongue carcinoma removal， including relatively large defects involving the tongue root or mouth floor. Both the free forearm flap and lateral antebrachial cutaneous nerve can be implanted simultaneously，and this leads to postoperative recovery of flap sensitivity. Free forearm flap implantation deserves further investigation，particularly for patients with recurrent tongue carcinoma receiving high-dose radiotherapy.

Key words: Tongue neoplasm, Free forearm flap, Lateral antebrachial cutaneous nerve, Sensory functions, Reconstruction, Application