Anterolateral Thigh Flap (anterolateral + thigh_flap)

Distribution by Scientific Domains


Selected Abstracts


Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 8 2008
Yur-Ren Kuo MD
Abstract Background. Extensive composite defects involving the lip and cheek present difficult reconstructive challenges. This study presents a technique using anterolateral thigh (ALT) flaps with vascularized fascia for large complex oral sphincter defect reconstruction. Methods. Fifteen patients who had undergone oral cancer ablation were enrolled in the study. The average area of intraoral lining and cheek,lip skin defects was 96.9 cm2. Upper-lip defects ranged 0% to 60%, and lower-lip defects ranged 20% to 80%. Skin and intraoral lining defects were replaced by an ALT fasciacutaneous flap. The vascularized fascia of the flap was used to provide lip suspension. Results. Flap survival was 100%. All but 1 patient had good static suspension. Nine patients had adequate oral competence without drooling, but 6 had occasional oral incontinence. All patients achieved an acceptable appearance. Conclusions. For extensive cheek,lip composite defects, ALT flap together with vascularized fascia has proven to be a useful option for functional reconstruction. © 2008 Wiley Periodicals, Inc. Head Neck 2008 [source]


Rehabilitation by means of osseointegrated implants in oral cancer patients with about four to six years follow-up

JOURNAL OF ORAL REHABILITATION, Issue 3 2006
J. SEKINE
summary, This paper describes the reconstruction of mandibular defects in four oral cancer patients using iliac crest bone grafts and osseointegrated implants. In three patients, reconstructive surgery using a reconstruction plate and free forearm skin flap was performed following tumour and segmental mandibular resection. After 7,9 months, mandibular reconstruction with a free iliac bone graft was carried out. In one patient, reconstructive surgery was performed with vascularized iliac bone grafting with an anterolateral thigh flap at the same time as the tumour resection. Fixtures were placed in the transplanted bone, and abutments were connected 6,9 months later together with vestibuloplasty. Gingival grafts were used to replace the skin flap around abutments. All implants survived throughout the approximately 4,6 years observation time. Marginal bone loss of the graft was originally several millimetres but less than 1·5 mm. Bone loss as well as management of peri-implant soft tissue was also discussed. [source]


Maxillary reconstruction using anterolateral thigh flap and bone grafts

MICROSURGERY, Issue 6 2009
Bernardo Bianchi M.D.
Background: Loss of the maxilla and midfacial bone buttresses after tumor resections can lead to severe functional and esthetic consequences. The loss of palate function may lead to oro-nasal communication, nasal speech, and oral intake difficulties. Several techniques have been proposed for maxillary defects reconstruction including prosthesis, locoregional flaps, or free flaps. The authors propose the use of anterolateral thigh free flap and iliac crest, or calvaria bone graft association for reconstruction of this kind of defects. Methods: Between November 2003 and June 2007, eight patients underwent maxillectomies, with preservation of the orbital contents and simultaneous reconstruction using this technique. Results: All the flaps were harvested and transplanted successfully. No major complication occurred and only one patient developed a palatal dehiscence with partial necrosis of the skin of the flap. There were no complications at the donor sites. Speech was assessed as normal in five patients, intelligible in two patients, and poor in one patient. Six patients returned to normal diets, while two patients were restricted to soft diets. The esthetic results were evaluated by the patients themselves as good (in five cases) and acceptable (in two cases). In the remaining case, the esthetic result was deemed to be poor, due to ectropion and poor color matching of the skin used for the external coverage. Conclusion: The good results obtained using this technique encourage the choice of the association of anterolateral thigh and bone grafts for reconstructing maxillary complex defects. © 2009 Wiley-Liss, Inc. Microsurgery 2009. [source]


Repair of buccal defects with anterolateral thigh flaps

MICROSURGERY, Issue 3 2006
Ömer Özkan M.D.
The ideal reconstructive method for the buccal mucosa should provide durable, stable coverage and a natural contour, while simultaneously minimizing morbidity of both the defect and donor sites. Since the first report of the anterolateral thigh flap in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft-tissue defects. From March 2004,April 2005, 24 free anterolateral thigh flaps were used to reconstruct buccal defects, including the retromolar trigone and as far as the oral commissure, and in some cases with extension to the neighboring palatal region and tongue. The study comprised 1 female and 23 male patients, with ages ranging from 26,63 years (mean age, 45.8 years). Two flaps required reoperation due to vascular compromise, and both were salvaged with arterial and venous anastomosis revisions, giving an overall success rate of 100%. Primary thinning of the flap was performed in 10 cases. In 2 cases, additional vastus lateralis muscle was included in the flap to fill the large defect. In 2 cases, marginal necrosis with dehiscence of the flap was observed, one of these patients having a history of atherosclerosis and diabetes mellitus (marginal skin necrosis and infection of the donor area were also observed in this patient). In 2 patients, seroma collection was observed in the neck at the dissection site. Chart reviews showed that most patients had a history of betel-nut chewing (95.8%) or a combination of smoking and betel-nut chewing (79.2%). During the follow-up period of 4,12 months, a sufficient level of mouth-opening with interincisal distances of 34 mm, 44 mm, and 48 mm was achieved in all 3 cases reconstructed after release of the trismus. Although it has some variations in the vascular pedicle, irregularity in derivation from the main vessels, and minimal morbidity of the donor site, the anterolateral thigh flap, with its evident functional, structural, and cosmetic advantages, can be considered an excellent and ideal flap option, and a first choice for most buccal defects. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source]


Penile resurfacing with vascularized fascia lata

MICROSURGERY, Issue 6 2005
Andreas I. Gravvanis M.D., Ph.D.
Penis resurfacing is a challenging procedure, and should simultaneously ensure erectile function, tactile sensibility, sexual satisfaction, and aesthetic integrity. This article presents three cases with penile skin defects treated by means of a pedicled fascia lata attached either to the tensor fascia lata (one case) or an anterolateral thigh flap (two cases). The cause of the wounds included electrical burn, Fournier's gangrene, and self-mutilation. The size of flaps ranged from 10,13 cm in width and 15,30 cm in length. All flaps included vascularized fascia lata, which covered part or the circumference of the penis. All flaps survived completely. The lateral cutaneous nerve of the thigh was included in the designed flaps in all instances, and normal protective sensation was recorded postoperatively. The patients reported normal erectile function and ability to perform intercourse. The flaps, though relatively bulky and hairy, had a good color and texture match with the penis and suprapubic region. Based on our limited experience, we believe that the anterolateral thigh flap has greater dimensions with a longer pedicle, and allows for greater flexibility in flap design compared to the tensor fascia lata flap. An anterolateral thigh flap can be safely thinned in a second stage, and it is our flap of choice for penis resurfacing. © 2005 Wiley-Liss, Inc. Microsurgery 25:462,468, 2005 [source]


Repair of buccal defects with anterolateral thigh flaps

MICROSURGERY, Issue 3 2006
Ömer Özkan M.D.
The ideal reconstructive method for the buccal mucosa should provide durable, stable coverage and a natural contour, while simultaneously minimizing morbidity of both the defect and donor sites. Since the first report of the anterolateral thigh flap in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft-tissue defects. From March 2004,April 2005, 24 free anterolateral thigh flaps were used to reconstruct buccal defects, including the retromolar trigone and as far as the oral commissure, and in some cases with extension to the neighboring palatal region and tongue. The study comprised 1 female and 23 male patients, with ages ranging from 26,63 years (mean age, 45.8 years). Two flaps required reoperation due to vascular compromise, and both were salvaged with arterial and venous anastomosis revisions, giving an overall success rate of 100%. Primary thinning of the flap was performed in 10 cases. In 2 cases, additional vastus lateralis muscle was included in the flap to fill the large defect. In 2 cases, marginal necrosis with dehiscence of the flap was observed, one of these patients having a history of atherosclerosis and diabetes mellitus (marginal skin necrosis and infection of the donor area were also observed in this patient). In 2 patients, seroma collection was observed in the neck at the dissection site. Chart reviews showed that most patients had a history of betel-nut chewing (95.8%) or a combination of smoking and betel-nut chewing (79.2%). During the follow-up period of 4,12 months, a sufficient level of mouth-opening with interincisal distances of 34 mm, 44 mm, and 48 mm was achieved in all 3 cases reconstructed after release of the trismus. Although it has some variations in the vascular pedicle, irregularity in derivation from the main vessels, and minimal morbidity of the donor site, the anterolateral thigh flap, with its evident functional, structural, and cosmetic advantages, can be considered an excellent and ideal flap option, and a first choice for most buccal defects. © 2006 Wiley-Liss, Inc. Microsurgery, 2006. [source]


Reconstruction of the Through-and-Through Anterior Mandibulectomy Defect: Indications and Limitations of the Double-Skin Paddle Fibular Free Flap,

THE LARYNGOSCOPE, Issue 8 2008
Frederic W.-B.
Abstract Objectives/Hypothesis: The purpose of this report is to describe our recent experience using a double-skin paddle fibular free flap (DSPFFF) for reconstruction of the through-and-through anterior mandibulectomy defect and to present a reconstructive algorithm based on the extent of lip and mental skin resection. Study Design: Retrospective review of 10 consecutive patients with through-and-through anterior mandibulectomy defects. Methods: Outcomes that were examined included methods of reconstruction based on the cutaneous defect, flap complications, fistula rate, and donor site complications. Results: Seven patients were reconstructed with a DSPFFF. For lip reconstruction, two patients were also concomitantly reconstructed with Karapandzic or lip advancement flaps. Three patients were reconstructed with both a fibular free flap and a second free flap (1 radial forearm fasciocutaneous flap and 2 anterolateral thigh flaps). The transverse dimensions of the DSPFFFs were as great as 15 cm. None of the patients developed a fistula. All free tissue transfers were successful. One patient developed partial loss of the fibular skin paddle used for submental skin replacement. Conclusions: DSPFFF is a safe and reliable way to reconstruct an anterior through-and-through mandibular defect. Indications for using a DSPFFF are 1) a cutaneous defect that lies at or below the plane of the reconstructed mandible, 2) a transverse width of the oral mucosa and cutaneous defect that does not exceed 15 cm (the approximate distance from the mid-calf to the anterior midline), and 3) a lip defect that, if present, can be reconstructed with local flaps. [source]