{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:09:52Z","timestamp":1747148992197,"version":"3.40.5"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The radial forearm free flap (RFFF) is considered a workhorse for head and neck cancer reconstructive surgery due to its generally consistent anatomy, pliability, long pedicle, and accessible harvest location.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 63\u2010year\u2010old male with trisomy 21 and recurrent midface basal cell carcinoma presented for surgical management. The patient underwent tumor resection including left infrastructure maxillectomy with ipsilateral rhinectomy. Preoperative Allen's test was normal; however, the planned osteocutaneous radial forearm free flap reconstruction was aborted intraoperatively due to aberrant vascular anatomy in the form of a diminutive radial artery branch. Reconstruction was instead performed with an anterolateral thigh free flap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patient recovered well in the hospital and was subsequently discharged to his care facility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Radial artery anomalies may be present among trisomy 21 patients making reconstruction with a RFFF not feasible, and thus preoperative Doppler ultrasound to assess arterial anatomy is essential in this population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27484","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T09:05:18Z","timestamp":1692263118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cautionary case for radial forearm free flap use in trisomy 21"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8408-3549","authenticated-orcid":false,"given":"Sophia","family":"Peifer","sequence":"first","affiliation":[{"name":"University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"Carey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Health System and Jackson Memorial Hospital  Miami Florida USA"},{"name":"Department of Otorhinolaryngology \u2013 Head and Neck Surgery University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Nisenbaum","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Health System and Jackson Memorial Hospital  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Leibowitz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Health System and Jackson Memorial Hospital  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Nicolli","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Miami Health System and Jackson Memorial Hospital  Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-6665(20)30589-2"},{"volume-title":"Radial Forearm Tissue Transfer","year":"2022","author":"Rengifo D","key":"e_1_2_7_3_1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000637\u2010198712000\u201000001"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1055\/S\u20100031\u20101279675"},{"volume-title":"Osteocutaneous Radial Forearm Flap","year":"2022","author":"Bigcas JLM","key":"e_1_2_7_6_1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.24863"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/MHN.2000.110728"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAOTO.2013.1357"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/ADC.61.9.885"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1046\/J.1469\u20107580.2001.19950547.X"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03207767"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.2880170403"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1055\/S\u20102007\u20101006814"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.1999.3294"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/CA.20087"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/S\u20102004\u2010861519"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJOM.2019.06.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022\u20105347(17)37931\u20104"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.JOTR.2013.07.002"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/0887\u20108994(95)00217\u20100"},{"key":"e_1_2_7_22_1","first-page":"5","article-title":"Congenital cardiovascular malformations in Chinese children with Down's syndrome\u2014PubMed","volume":"102","author":"Lo N","year":"1989","journal-title":"Chin Med J"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/J.1399\u20106576.2008.01804.X"}],"container-title":["Head &amp; 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