Related Experiment Video
Updated: Aug 5, 2026
09:14
Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
Published on: December 30, 2025
Cranial Vault and Scalp Reconstruction Utilizing Anterolateral Thigh Free Tissue Transfer
Conrad Blunck1, Stephen P Hadford1, Lacey Magee1
1Department of Otolaryngology - Head and Neck Surgery, Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA.
The Laryngoscope
|July 26, 2026
Summary
The anterolateral thigh (ALT) free flap is versatile for cranial reconstruction. Fascia lata flaps showed lower complication and failure rates compared to fasciocutaneous or adipofascial flaps in this cranioplasty study.
Area of Science:
- Plastic Surgery
- Craniofacial Reconstruction
- Microsurgery
Background:
- Cranioplasty requires neural protection, dural integrity, and contour restoration.
- The anterolateral thigh (ALT) free flap is a versatile option for complex cranial defects.
Purpose of the Study:
- To compare the utilization and outcomes of three ALT flap types for cranioplasty.
- To evaluate complication and flap failure rates across different ALT flap variations.
Main Methods:
- Retrospective review of 72 patients undergoing ALT cranioplasty (01/01/2019–02/01/2025).
- Flap types included fascia lata only, adipofascial, and fasciocutaneous.
- Data collected on utilization, outcomes, and complications.
Main Results:
- 79 ALT free tissue transfers were performed: fascia lata (n=22), fasciocutaneous (n=35), adipofascial (n=22).
- Fasciocutaneous and adipofascial flaps had higher complication rates (29%, 27%) versus fascial alone (5%).
- Flap failure rates were higher for fasciocutaneous (11%) compared to adipofascial (5%) and fascial alone (0%).
Conclusions:
- The ALT free flap is an adaptable and effective reconstructive option for complex scalp and cranial vault defects.
- Fascia lata alone may offer a lower complication profile for certain cranioplasty cases.
