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Updated: Jul 2, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Further experience with adipofascial ALT flap for oral cavity reconstruction
1Department of Plastic, Reconstructive and Aesthetic Surgery, University of Florence, Faculty of Medicine and Surgery, Largo Palagi 1, 50134 Florence, Italy.
Background:
The restoration of the buccal mucosa is the main challenge for the plastic surgeon. In the past 15 years the free radial forearm flap has been widely used, due to its thickness and pliability. More recently, the anterolateral thigh free flap has become the customary flap in oral cavity reconstruction.
Methods:
Six patients affected by oral cavity tumours underwent microsurgical reconstruction with the adipofascial anterolateral thigh free flap between December 2005 and December 2006.
Results:
One flap was lost due to venous thrombosis. In the other five flaps the postoperative period was uneventful. The patients are still free from disease. Multiple biopsies were performed to compare the neo-mucosa with the native. No relevant differences have emerged.
Conclusions:
Replacing tissue with like tissue should be the surgeon's aim. In the authors' opinion, the adipofascial variation of the anterolateral thigh free flap is the ideal replacement for oral cavity mucosa, allowing good fixation and mobility, and optimum aesthetic and functional results. It can be thinned to fit the defect with low risk. The patching condition resulting from fasciocutaneous flaps reconstruction is avoided. The remucosalisation of the flap occurs in about 1 month for the neo-mucosal functions as it does in the native tissue. It is non-hair bearing and is not influenced by postoperative radiotherapy.