Our experience with super-thin anterolateral thigh flap for intraoral reconstruction

According to the literature, in our country, the first choice for the reconstruction of extensive defects after the removal of locally advanced oral tumors is free flap reconstruction, which achieves the best functional outcome. We investigated whether the anterolateral thigh flap, which can be closed primarily at the donor site and is usually indicated for large or complex defects, can be adapted for thin defects, as well.

Within the framework of a pilot study, 10 patients who underwent radical ablative surgery for oral squamous cell carcinoma were reconstructed with an anterolateral thigh flap harvested in the superficial fascia plane. We compared our results with those of 42 oral cavity radial forearm flap reconstruction procedures.

Of the 10 patients who underwent reconstruction with a thinned anterolateral thigh flap seven underwent surgery for sublingual tumor and three for tongue tumors. All the flaps healed uneventfully. The average flap thickness was 9.25 mm and the average pedicle length was 11.7 cm, which was similar to that of the radial forearm flap (8.6 mm and 12.1 cm). No complications were observed at the donor site, and in every case, we were able to close the donor site primary.

The anterolateral free thigh flap harvested in the superficial fascia plane could be an appropriate choice for functional preservation and closure of the oral cavity. Considering that it is similar to the radial forearm flap in terms of thickness and pedicle length but has a more favorable donor site morbidity, its wider use is recommended.