Beavertail modification of the radial forearm free flap in base of tongue reconstruction: technique and functional outcomes.

BACKGROUND Head and neck oncologists are often confronted with the difficult challenge of balancing cancer cure with the preservation of function when deciding the patient's best treatment protocol. This task is especially difficult in cancer of the base of tongue. The purpose of this manuscript is to describe the beavertail modification of the radial forearm-free flap in base of tongue reconstruction. METHODS Thirty-one consecutive patients treated for base of tongue cancer with primary surgery were followed prospectively. The technique of the beavertail modification is described. Swallowing and speech function were assessed preoperatively and postoperatively. RESULTS All the flaps survived. Thirty (97%) patients started consuming oral diet within 1 year, and all had normal speech intelligibility. CONCLUSIONS The beavertail modification of the radial forearm arm flap seems to provide the reconstructive elements that allow patients with large base of tongue extirpations to develop functional swallowing and speech production postoperatively.