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Anterolateral thigh adipofascial flap versatile for mucosal reconstructions

The anterolateral thigh adipofascial flap can be harvested as a thin, pliable and variable area free flap with minimal donor site morbidity for several types of oral cavity and nasal reconstruction.

Researchers retrospectively reviewed data for 30 patients who underwent anterolateral thigh adipofascial flap (ALTAF) for head and neck reconstruction to evaluate flap survival and goal-oriented results.

The tongue, palate, gingiva, floor of the mouth and nasal mucosa were included as sites of reconstruction. Mean follow-up was 13.2 months.

Flaps were most commonly performed for malignant neoplasms (50%), followed by exposed alveolar coverage secondary to radiotherapy or osteoradionecrosis (33%) and benign neoplasms (17%), according to the researchers. The overall size of the flaps ranged from 70 cm² to 200 cm².

Although the researchers found one report of flap failure, no partial-flap failures, instances of wound breakdown or need for operative microvascular revisions were reported.

All donor sites were closed primarily, and there were no donor-site complications. However, three patients needed late revision to correct tethering of the mobile tongue that resulted from postoperative scarring. – by Abigail Sutton

Disclosure: The authors have no relevant financial disclosures.