title: Refinement of the myocutaneous anterolateral thigh flap for reconstruction of frontonasal fistula defects.
abstract: Frontonasal fistulas can lead to life-threatening intracranial infections. Our refinement of the myocutaneous anterolateral thigh (ALT) flap for treating these fistulas is described.
  
  
  
  A retrospective review of the microsurgical treatment of frontonasal fistulas is presented. Demographics, etiologies, outcomes, and complications were evaluated.
  
  
  
  Ten myocutaneous ALT flaps were used to reconstruct frontonasal fistula. The mean follow-up was 35 ± 2.5 months. Nine fistulas were secondary to oncologic resections, and one was due to a traumatic origin. Complications included a recurrent abscess in 1 case (10%); there were no cases of cerebrospinal fluid (CSF) leak or flap loss. Preoperative intracranial infections were present in 7 cases, with 6 successfully resolving their infection after surgical intervention and flap obliteration of their fistulas.
  
  
  
  Refinements in the myocutaneous ALT flap design have been illustrated to provide robust dead-space obliteration with vascularized muscle and reliable simultaneous scalp coverage in the treatment of frontonasal fistulas. © 2015 Wiley Periodicals, Inc. Head Neck 38: E552-E558, 2016.
authors: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan.|Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Chih-Wei
authors: CW
authors: Wu
authors: Department of Plastic Surgery, Division of Burn, Wound, and Trauma, Wexner Medical Center at the Ohio State University, Columbus, Ohio.|Department of Plastic and Reconstructive Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
authors: Ian L
authors: IL
authors: Valerio
authors: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan.|Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Jung-Ju
authors: JJ
authors: Huang
authors: Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Kai-Ping
authors: KP
authors: Chang
authors: Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taoyuan, Taiwan.|Center for Tissue Engineering, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors: Ming-Huei
authors: MH
authors: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005402:Fistula / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064827:Myocutaneous Flap / Q000637:transplantation*; D010256:Paranasal Sinuses / Q000601:surgery*; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013848:Thigh
keywords: anterolateral thigh (ALT) flap; cerebrospinal fluid (CSF) leakage; frontonasal fistulas; head and neck reconstruction; myocutaneous ALT flap; vascularized free tissue transfer