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Although an elegant biological closure of a large defect may ultimately be optimal, the patient usually first presents with a large defect of the tissue and osseous boundaries. It is the responsibility of the treating surgeon to achieve the best achievable surgical and aesthetic outcomes. The emphasis of a reconstructive surgeon is to close the defects with the best possible aesthetic and functional outcomes. Prior to reconstructing large defects in the oral cavity, the first step is to define the defect by delineating the boundaries of it. The surgeon should have a thorough understanding of the anatomy of the oral cavity, the anatomy of the orofacial region, and the surgical techniques available.
Children with large, complex congenital anomalies of the oral cavity pose a substantial challenge for clinicians and require precise planning, appropriate surgical techniques, and successful outcomes. The use of microvascular-based techniques can allow for more standardized surgical approaches with better aesthetic and functional outcomes, compared with traditional approaches. In this review we examined the recent literature on microvascular-based surgical techniques used for tongue and upper lip reconstruction, with a focus on the various advantages of the free radial forearm flap, particularly in terms of its use in reconstructing complex oral cavity defects.
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