Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck

PLoS One. 2014 Sep 2;9(9):e106326. doi: 10.1371/journal.pone.0106326. eCollection 2014.

Abstract

The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14-23) cm and the mean width was 4.9 (range: 2.5-7) cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Intraoperative Care
  • Male
  • Middle Aged
  • Plastic Surgery Procedures*
  • Preoperative Care
  • Squamous Cell Carcinoma of Head and Neck
  • Surgical Flaps / surgery*
  • Thigh / surgery*

Grants and funding

The National Natural Sciences Foundation of China (Grant No. 81000445) and the State Key Specialist Construction Projects of China provided funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.