Advancing Reconstructive Surgery

Doctors' research brings better procedures and new hope to patients with facial cancers

Reconstructing the neck, head, and jaw after removing malignant tumors has always challenged surgeons. Until recently, one of their best options—to use tissue and bone from the forearm—was abandoned because it left the arm vulnerable to fracture and future complications. But thanks to a pioneering procedure called Osteocutaneous Radial Forearm Flap, patients undergoing reconstructive facial surgery can enjoy improved recovery and quality of life.

And the surgeons at The University of Kansas Hospital found it. Reaching across disciplines, E. Bruce Toby, MD, chair of orthopedic surgery, Terance Tsue, MD, otolaryngology and head and neck surgeon, and Douglas Girod, MD, chair of otolaryngology, developed a procedure to use the radial bone and tissue—and eliminate the tendency for fracture.

Listen to Dr. Tsue discuss osteocutaneous radial forearm flap surgery and how it treats the whole patient, not just the condition. Right-click to download the audio file.

"We knew the forearm was the best site for tissue and bone to reconstruct the mouth, tongue, and cheek," Dr. Girod said. But the outcomes weren't acceptable: 30 to 50 percent of these procedures resulted in fractures, loss of function, and further reconstructive surgery.

"We treated the donor site, the forearm, prophylactically," said Dr. Girod. "We treated it as if it were already broken.

"We knew there had to be a better way."

In an Osteocutaneous Radial Forearm Flap, the surgeons insert a titanium plate into the arm to strengthen it, which prevents future fractures, retains the arm’s function, and yields faster recovery rates.

"With this procedure, we can give patients the best, and most effective, reconstruction for the mouth and still rebuild the jaw at the same time, all with one operation," said Dr. Girod.

Drs. Girod, Tsue, and Toby have shared their knowledge with the medical community. Today, this technique is used in multiple centers nationwide.

"This procedure gives our patients better options, better reconstruction, and a better healing experience, said Dr. Girod." It's really about finding ways to give them a more normal life after very extensive surgery."