The anterolateral thigh flap: radial forearm's "big brother" for extensive soft tissue head and neck defects.
OBJECTIVE
The anterolateral thigh flap has recently been rediscovered in Asia as a perforator flap. The objective of this study was to describe the reliability and donor morbidity of the anterolateral thigh flap for head and neck reconstruction without transmuscular perforator dissection.


METHODS
Consecutive case series by a single surgeon.


METHODS
A regional tertiary-referral head, neck, and skull base surgical oncology center.


METHODS
The first 34 consecutive patients.


METHODS
Microvascular reconstruction with an anterolateral thigh free flap.


METHODS
Primary insufficiency, partial necrosis, complete necrosis, and donor morbidity rates.


RESULTS
Two flaps necrosed partially (6%). No flaps demonstrated primary insufficiency, necrosed completely, or incurred significant donor morbidity.


CONCLUSIONS
The anterolateral thigh flap can be reliably harvested without transmuscular perforator dissection and without incurring serious donor morbidity. It possesses workhorse attributes (no repositioning, remote from defect, long pedicle) and is extremely versatile (one is able to independently tailor the skin and muscle), making it ideal for the heterogeneous group of extensive soft tissue head and neck defects. When a forearm flap will likely be too thin or too morbid, the anterolateral thigh flap can be considered its "big brother."
Lueg
Edgar A
EA
Microvascular Reconstructive Head & Neck Surgery Service, Regional Head, Neck, & Skullbase Surgical Oncology Center, Southern California Permanente Medical Group, Kaiser Foundation Los Angeles Medical Center, 90027, USA. edgar.a.lueg@kp.org
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D013848:Thigh; D016896:Treatment Outcome