title: Reconstructive Indications of Anterolateral Thigh Free Flaps in Head and Neck Reconstruction.
abstract: Anterolateral thigh (ALT) free flap is a common flap with multitude of indications. The purpose of this article is to review the reconstructive indications of the flap in head and neck defects. This is a retrospective study of 194 consecutive ALT flaps. Data including patient characteristics (age, sex, comorbidities), disease characteristics (histology, T stage), and flap characteristics (size of the flap, type of closure of ALT donor site) were collected. The outcome in terms of flap success rate, surgical, and donor site morbidity were studied. A total of 194 flaps were performed in 193 patients over a period of 10 years. Mean age of the patients was 55 years (range 16-80 years). Out of the 193 patients, 91 (47.1%) patients had oromandibular defects, 52 (26.9%) had tongue defects, 15 (7.7%) had pharyngeal defects, 17 (8.8%) had skull base defects, 4 (2%) had scalp defects, and 14 (7.2%) had contour defects of the neck. The overall flap success rate was 95.8% (8 total flap loss out of 194). Hypertrophic scar was the commonest donor site problem seen in 20 (10.3%) patients. This study shows the versatility of free ALT flap in head and neck reconstruction. It is a reliable and safe. Donor site morbidity is minimal.
authors.affiliation: Department of Surgical Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Khadakban
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Kudpaje
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Krishnakumar
authors.initials: K
authors.lastname: Thankappan
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Kiran
authors.initials: K
authors.lastname: Jayaprasad
authors.affiliation: Department of Surgical Oncology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Tejal
authors.initials: T
authors.lastname: Gorasia
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Sivakumar
authors.initials: S
authors.lastname: Vidhyadharan
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Mathew
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Mohit
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Department of Head and Neck, Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
authors.forename: Subramania
authors.initials: S
authors.lastname: Iyer
keywords: anterolateral thigh flap; free flaps; head and neck cancer; head and neck reconstruction; oromandibular defect