title: Versatility of the free anterolateral thigh flap for reconstruction of head and neck defects.
abstract: OBJECTIVE
  The anterolateral thigh flap has many advantages in head and neck reconstruction. However, it has not yet come into widespread use because of the anatomic variations of its perforators. Herein, we describe a safe operative technique related to the patterns of the perforators and discuss its wide versatility.
  
  
  METHODS
  A national cancer center hospital.
  
  
  METHODS
  Thirty-eight anterolateral thigh flaps were transferred. Confirmation and dissection of the flap pedicle were simultaneously performed with tumor resection. The design and elevation of the flap were carried out immediately after the tumor resection was completed.
  
  
  RESULTS
  From the study of the anatomic variations of the perforators, septocutaneous patterns were recognized in 10 cases (26.3%) and musculocutaneous patterns in 28 cases (73.7%). All flaps were easily and safely elevated with our techniques. Thirty-six flaps survived. Partial necrosis was noted owing to excessive thinning procedure in one patient and total necrosis was noted owing to venous thrombosis at the anastomosis part in another patient.
  
  
  CONCLUSIONS
  We found that the anterolateral thigh flap has numerous advantages. It is possible to perform the flap elevation and the tumor resection simultaneously. The flap is generally thin and is suitable for reconstruction of intraoral defects. Combined flaps with neighboring tissues and other, distant flaps can be used. Furthermore, since our technique minimizes the problems of confirmation and dissection of the perforators, we conclude that this flap can be successfully used to repair a variety of large defects of the head and neck.
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kimata
authors.forename: K
authors.initials: K
authors.lastname: Uchiyama
authors.forename: S
authors.initials: S
authors.lastname: Ebihara
authors.forename: T
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: M
authors.initials: M
authors.lastname: Asai
authors.forename: M
authors.initials: M
authors.lastname: Saikawa
authors.forename: R
authors.initials: R
authors.lastname: Hayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Jitsuiki
authors.forename: K
authors.initials: K
authors.lastname: Majima
authors.forename: W
authors.initials: W
authors.lastname: Ohyama
authors.forename: T
authors.initials: T
authors.lastname: Haneda
authors.forename: T
authors.initials: T
authors.lastname: Nakatsuka
authors.forename: K
authors.initials: K
authors.lastname: Harii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D013524:Surgical Flaps / Q000098:blood supply / Q000473:pathology; D013848:Thigh