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Original Investigation |

Anterolateral Thigh Adipofascial Flap in Mucosal Reconstruction ONLINE FIRST

Peter C. Revenaugh, MD1; Timothy M. Haffey, MD1; Rahul Seth, MD1; Michael A. Fritz, MD1
[+] Author Affiliations
1Head and Neck Institute, Department of Otolaryngology–Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio
JAMA Facial Plast Surg. Published online August 14, 2014. doi:10.1001/jamafacial.2014.447
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Importance  This study describes a reliable technique for mucosal reconstruction of large defects using components of a common free flap technique.

Objective  To review the harvest technique and the varied scenarios in which the anterolateral thigh adipofascial flap (ALTAF) can be used for mucosal restoration in oral cavity and nasal reconstruction.

Design, Setting, and Participants  A retrospective review of the medical records of 51 consecutive patients was conducted. The patients had undergone ALTAF head and neck reconstruction between January 2009 and June 2013. Each case was reviewed, and flap survival and goal-oriented results were evaluated.

Results  Thirty patients met the inclusion criteria and were included in the analysis. The mean patient age was 60.6 years. Reconstruction sites included the tongue, palate, gingiva, floor of the mouth, and nasal mucosa. All mucosal reconstructions maintained function and form of replaced and preserved tissues. One patient (3%) experienced flap failure that was reconstructed with a contralateral adipofascial flap with excellent outcome. Three patients (10%) required minor flap revisions. There were no other complications.

Conclusions and Relevance  The ALTAF is a versatile flap easily harvested for use in several types of mucosal reconstructions.

Level of Evidence  4.

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Figures

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Figure 1.
Representative Thin Adipofascial Flap

Vascular arcade is clearly visible centrally.

Graphic Jump Location
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Figure 2.
Postoperative Example of Near-Total Palate Reconstruction With Anterolateral Thigh Adipofascial Flap

Oral mucosa has enclosed the reconstruction.

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Figure 3.
Operative Example of Total Nasal Reconstruction With Anterolateral Thigh Adipofascial Flap

The thin, pliable flap can easily conform to the shape of the nasal cavity.

Graphic Jump Location

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