title: Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence.
abstract: BACKGROUND
  Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.
  
  
  RESULTS
  We describe a case of a 56-year-old man with stomal recurrence after total laryngectomy treated by the use of a tubed anterolateral thigh (ALT) flap to elongate the shortened trachea and simultaneously cover the cervical skin defect.
  
  
  CONCLUSIONS
  The ALT can be accepted as an ideal free-flap choice for stomal recurrence, because it has maximal reconstructive capacity and produces minimal donor-site morbidity.
authors.affiliation: ENT Department, S. Orsola-Malpighi Hospital, Bologna University, Bologna, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Caliceti
authors.forename: Ottavio
authors.initials: O
authors.lastname: Piccin
authors.forename: Ottavio
authors.initials: O
authors.lastname: Cavicchi
authors.forename: Federico
authors.initials: F
authors.lastname: Contedini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cipriani
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D018570:Risk Assessment; D013524:Surgical Flaps; D054047:Surgical Stomas / Q000473:pathology; D013848:Thigh / Q000601:surgery; D014134:Tracheal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery*; D016896:Treatment Outcome