Assessment of volume changes of radial forearm free flaps in head and neck cancer: long-term results.

The goal of this study was to evaluate changes in radial forearm free flap (RFFF) volumes after 5 years of follow-up after ablative tumor surgery in the head and neck. Eighteen patients underwent RFFF reconstruction. Flap volumes were measured by computerized segmentation of CT or MR images. Average postoperative 3 months, and 1, 3, and 5 years flap volumes were 167.4, 129.0, 104.9, and 88.7 cm³, respectively. Average percentage changes between 3 months and 1-year, 3 months and 3-years, and 3 months and 5-years scans were 20.4, 30.3, and 42.7%, respectively. A significant relation was found between postoperative irradiation and RFFF volume changes from 3 months to 5 years (p=0.046). Overcorrection with a 40% greater RFFF volume is recommended for the reconstruction of tumor-related defects in the head and neck.