ABSTRACT
The radial forearm flap is harvested as a fasciocutaneous, septocutaneous, fascial or osteocutaneous flap. A sensory nerve or the palmaris longus tendon may also be included. The soft tissue flap is an accepted 'workhorse' for oral reconstruction. The flap is straightforward to raise and has a long vascular pedicle. It is employed for reconstructing mobile areas of the oral cavity and oropharynx. It retains a 'niche' role for small-volume bone defects of the anterior or partial maxillary alveolus, central palate, nasal bone and orbital rim. It may still be useful for the thin edentulous mandible, particularly if associated with a significant soft tissue defect and/or implant placement is unlikely. Fascia-only flaps are less dimensionally stable and heal by secondary 'mucosalization' and are used for small palatal defects or over areas of exposed bone. A fascial flap may be pre-laminated with skin or a mucosal graft as a delayed procedure for elective reconstruction.
