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Clinical Article
The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases
Article first published online: 20 JAN 2012
DOI: 10.1002/micr.20952
Copyright © 2012 Wiley Periodicals, Inc.
Additional Information
How to Cite
Bianchi, B., Ferri, A., Ferrari, S., Copelli, C., Boni, P., Ferri, T. and Sesenna, E. (2012), The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases. Microsurgery, 32: 87–95. doi: 10.1002/micr.20952
Publication History
- Issue published online: 27 JAN 2012
- Article first published online: 20 JAN 2012
- Manuscript Accepted: 1 AUG 2011
- Manuscript Received: 30 MAY 2011
- Abstract
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Abstract
Background:
Applications of the free anterolateral thigh (ALT) musculocutaneous flap have been largely underestimated compared with indications for fasciocutaneous or perforator flaps. In this article, the authors critically review the experience of a single surgeon with the free ALT musculocutaneous flap for head and neck reconstruction, focusing on its applications in different cephalic areas and on advantages and disadvantages of this technique.
Patients and methods:
Ninety-two patients were treated using a free ALT musculocutaneous flap. Reconstructed areas included tongue, oropharynx, mandible, maxilla, hypopharynx, cheek, and skull base.
Results:
Flap survival rate was 97.8%. Donor site morbidity consisted in two cases of partial necrosis of the skin graft used its closure with a final donor site complication rate of 2.2%. Overall results showed an 89% of patients returned to a normal or a soft diet. Speech was good or intelligible in 88% and cosmesis resulted good or acceptable in 89% of cases.
Conclusion:
The free ALT musculocutaneous flap offers unique advantages in head and neck reconstructions including adequate bulk when needed, obliteration of dead space, support for the soft tissues of the face, low donor-site morbidity, and harvesting without needing for perforators dissection, allowing for optimal patient outcome. Excessive bulky and thickness of subcutaneous tissue, especially in occidental population, have to be considered as the main disadvantages of this technique, finally the high incidence of hairy skin in thigh area in male patients and donor site scars associated with the use of skin grafts have to be considered as supplementary minor drawbacks. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.