Lateral arm free tissue transfer for parotid reconstruction: A pictorial essay.

BACKGROUND: The goals of parotid reconstruction are to provide accurate volume reconstruction of the defect while minimizing ptosis, optimize color match to surrounding facial skin, maintain anatomic position of the auricle, and to perform facial nerve rehabilitation in cases in which the facial nerve is removed. METHODS AND RESULTS: For many complex parotid defects, the lateral arm free tissue transfer achieves these reconstructive goals and is the ideal donor site for microvascular reconstruction. In this pictorial essay, we describe the anatomy, harvest, inset, and reconstructive advantages of the lateral arm free tissue transfer in complex parotid reconstruction. CONCLUSIONS: The lateral arm donor site provides well-compartmentalized adipose tissue that resists ptosis, favorable color match to facial skin, and the posterior cutaneous nerve to the forearm may be used as a nerve graft for facial nerve rehabilitation. These reconstructive advantages make the lateral arm donor site our primary reconstructive option for complex parotid defects. (c) 2017 Wiley Periodicals, Inc. Head Neck 39: 1015-1019, 2017.