title: [The application of free anterolateral thigh flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defects].
abstract: OBJECTIVE
  To study the short-term results and technological improvement of free anterolateral thigh (ALT) flaps in the reconstruction of circumferential hypopharyngeal defects.
  
  
  METHODS
  The free ALT flap with a reporter skin paddle was used in 22 cases with circumferential hypopharyngeal defects. The short-term results of reconstructive surgeries and key points, advantages and complications of this technique were summarized.
  
  
  RESULTS
  The length of circumferential hypopharyngeal defects ranged from 7 to 9 cm. ALT flap with an area of (8-9) cm × (11-18) cm was harvested. A reporter skin island with the skin area of (2.0-3.0) cm × (2.5-4.0) cm was designed. 91% (20/22) of ALT flaps survived. Two cases with flap necrosis underwent second reconstruction with a pedicled pectoralis major flap. All the patients had patent anastomotic lumen. Good postoperative subjective swallowing evaluation was obtained in 59% (13/22) of patients; 41% (9/22) of patients had acceptable swallowing results. Three patients (14%) presented with postoperative pharyngocutaneous fistula. One case recovered spontaneously in short-term and other two cases received the second reconstructive surgery.
  
  
  CONCLUSIONS
  The application of free ALT flap with a reporter skin paddle in the reconstruction of circumferential hypopharyngeal defect is technologically easy and reliable, with satisfying swallowing function and limited trauma.
authors.affiliation: Department of Head and Neck Surgery, SUN Yat-sen University Cancer Center, Guangzhou 510060, China; Email: liuwwei@mail.sysu.edu.cn.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Xiamen 515031, China.
authors.forename: Hanwei
authors.initials: H
authors.lastname: Peng
authors.forename: Xuekui
authors.initials: X
authors.lastname: Liu
authors.forename: Zhuming
authors.initials: Z
authors.lastname: Guo
mesh_terms: D058752:Free Tissue Flaps; D006801:Humans; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000601:surgery*; D019651:Plastic Surgery Procedures; D016038:Skin Transplantation; D013848:Thigh