The radial forearm free flap versus the nasolabial flap in adults having reconstructive surgery for oral cancer : a comparison of quality of life outcomes

Abstract

Background : Surgical resection is the preferred treatment for tongue cancer. The Radial Forearm Free Flap (RFFF) has classically been used in oral reconstructions, however, there has been research into an alternative option in the form of the Nasolabial Flap (NLF). Surgical research is becoming more and more focussed on Quality of Life (QOL) outcomes as a way to measure a successful recovery. As a result, this review has focused on QOL as well as functional outcomes. Objective : The aim of this review is to determine if there are better QOL outcomes between patients undergoing tongue reconstruction with the NLF or the RFFF. The quality and limitations of the included papers will be discussed. Methods : Four databases were searched using set search terms and inclusion/exclusion criteria. These searches yielded fourteen final papers which were assessed using a CASP checklist and a bias tool for quality. Results : A variety of outcome measures were featured; despite this, all the papers found good functional and QOL results at follow-up. There were problems with bias throughout all the papers and several reoccurring limitations such as small sample size and the retrospective nature of all but one study. Conclusion : Due to the significant amount of bias found, the overall low quality of literature available, and discrepancies between outcome measures, further research is needed in the form of a long-term prospective study with a larger cohort that includes objective outcome measures.