Thinned Anterolateral Thigh Cutaneous Flap and Radial Fasciocutaneous Forearm Flap for Reconstruction of Oral Defects: Comparison of Donor Site Morbidity

Loreti, Andrea; Di Lella, Giovanni; Vetrano, Stefano; Tedaldi, Massimiliano; Dell'Osso, Aldo; Poladas, Giuseppe

doi:10.1016/j.joms.2007.09.021

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 66, Issue 6 , Pages 1093-1098, June 2008

Thinned Anterolateral Thigh Cutaneous Flap and Radial Fasciocutaneous Forearm Flap for Reconstruction of Oral Defects: Comparison of Donor Site Morbidity

Andrea Loreti, MD
- Plastic Surgery Consultant, Breast, Plastic, and Reconstructive Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
- Address correspondence and reprint requests to Dr Loreti: Via Capo D'Africa 23, 00184 Rome, Italy
Giovanni Di Lella, MD
- Ear, Nose, and Throat and Maxillofacial Surgery Consultant, Maxillofacial Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Stefano Vetrano, MD
- Maxillofacial Surgery Consultant, Maxillofacial Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Massimiliano Tedaldi, MD
- Resident, Maxillofacial Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Aldo Dell'Osso, MD
- Head, Breast, Plastic, and Reconstructive Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Giuseppe Poladas, MD
- Head, Maxillofacial Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.

Purpose

The thinned anterolateral thigh flap (tALT) has been utilized in clinical applications for soft tissue reconstruction. This flap has many advantages: no major artery is sacrificed; functional and esthetic results are often good. The purpose of this study is to investigate the esthetic outcome of the donor site after reconstruction of oral defects with tALT compared to the radial fasciocutaneous forearm flap (RFFF).

Patients and Methods

Between January 2003 and December 2005, 42 patients affected by oral squamous cell carcinoma (27 males, 15 females; age range: 34-82 years, mean age, 61.4 years) received microsurgical reconstruction. We treated 17 patients with RFFF and 25 cases with tALT.

Results

The RFFF group showed a success rate of 94.2% with only 1 total flap loss due to not reversible venous trombosis. In the tALT group we accomplished a 100% flap survival. Functional results at donor site in the RFFF group showed a persistent forearm movement impairment in about 30% of cases and sensitivity alterations in skin graft area in 75% of patients; in the tALT group we noticed only a transitory gait impairment in 1 patient; no clinical signs of circulatory disturbance were observed and no sensory disturbance of the thigh was reported.

Conclusions

In our experience, we found the thinned ALT coutaneous flap the ideal soft tissue flap in oral reconstruction. This flap presents functional results at the receiving site with the additional advantage of minimal donor-site morbidity and a high level of patient satisfaction.