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J Reconstr Microsurg 2002; 18(3): 141-146
DOI: 10.1055/s-2002-28463
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Role of the Anterolateral Thigh Flap in Head and Neck Reconstruction: Advantages of Moderate Skin and Subcutaneous Thickness

Bin Nakayama1 , Ikuo Hyodo1 , Yasuhisa Hasegawa2 , Yasushi Fujimoto2 , Hidehiro Matsuura2 , Hiroshi Yatsuya3 , Shuhei Torii1
  • 1Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • 2Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
  • 3Department of Public Health, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Publication History

Publication Date:
13 May 2002 (online)

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ABSTRACT

Skin-flap thickness is an important consideration when choosing a free flap for head and neck reconstruction. The anterolateral thigh flap, the rectus abdominis flap, and the radial forearm flap, which included the epidermis, the dermal, and the subcutaneous layers, were measured using ultrasonography in 31 patients. The mean skin and subcutaneous thickness of the anterolateral thigh flap was 7.1 mm; the rectus abdominis flap was 13.7 mm; and the radial forearm flap was 2.1 mm. Further analysis revealed a statistically significant difference among the skin and subcutaneous thickness of the three flap groups. Of the 44 anterolateral thigh flap transfers done for head and neck reconstruction after cancer ablative surgery, 41 (93.2 percent) were transferred successfully.

The anterolateral thigh flap creates a moderately thick skin flap, and is less variable in thickness across its area than is the rectus abdominis flap. The flap is adaptable for reconstruction of head and neck soft-tissue defects.

KEYWORDS

Anterolateral thigh flap - head and neck soft-tissue defects - post-cancer ablative surgery

REFERENCES

  • 1 Koshima I, Fukuda H, Yamamoto H. Free anterolateral thigh flaps for reconstruction of head and neck defects.  Plast Reconstr Surg . 1993;  92 421-28
    CrossrefPubMedSearch in Google Scholar
  • 2 Kimata Y, Uchiyama K, Ebihara S. Versatility of the free anterolateral thigh flap for reconstruction of head and neck defects.  Arch Otolaryngol Head Neck Surg . 1997;  123 1325-31
    CrossrefPubMedSearch in Google Scholar
  • 3 Kimata Y, Uchiyama K, Ebihara S. Anatomic variations and technical problems of the anterolateral thigh flap: a report of 74 cases.  Plast Reconstr Surg . 1998;  102 1517-23
    CrossrefPubMedSearch in Google Scholar
  • 4 Shieh S J, Chin H Y, Yu J C. Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation.  Plast Reconstr Surg . 2000;  105 2349-57
    CrossrefPubMedSearch in Google Scholar
  • 5 Jacobson M C, Franssen E, Fliss D M. Free forearm flap in oral reconstruction: functional outcome.  Arch Otolaryngol Head Neck Surg . 1995;  121 959-64
    CrossrefPubMedSearch in Google Scholar
  • 6 Nakatsuka T, Harii K, Yamada A. Versatility of a free inferior rectus abdominis flap for head and neck reconstruction: analysis of 200 cases.  Plast Reconstr Surg . 1994;  93 762-69
    CrossrefPubMedSearch in Google Scholar
  • 7 Koshima I, Moriguchi T, Soeda S. Free thin paraumbilical perforator-based flaps.  Ann Plast Surg . 1992;  29 12-17
    CrossrefPubMedSearch in Google Scholar
  • 8 Akizuki T, Harii K, Yamada A. Extremely thinned inferior rectus abdominis free flap.  Plast Reconstr Surg . 1993;  91 936-41
    PubMedSearch in Google Scholar
  • 9 Kimura N, Satoh K. Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap.  Plast Reconstr Surg . 1996;  97 985-92
    CrossrefPubMedSearch in Google Scholar
  • 10 Miller M J, Reece G P, Marchi M. Lateral thigh free flap in head and neck reconstruction.  Plast Reconstr Surg . 1995;  96 334-40
    PubMedSearch in Google Scholar
  • 11 Shimizu T, Fisher D R, Carmichael S W. An anatomic comparison of septocutaneous free flaps from the thigh region.  Ann Plast Surg . 1997;  38 604-10
    CrossrefPubMedSearch in Google Scholar
  • 12 Balta P, Ward M, Tomkins A. Ultrasound for measurement of subcutaneous fat.  Lancet . 1981;  1 504-5
    PubMedSearch in Google Scholar
  • 13 Weiss L W, Clark F C. Ultrasonic protocols for separately measuring subcutaneous fat and skeletal muscle thickness in the calf area.  Phys Ther . 1985;  65 477-81
    PubMedSearch in Google Scholar
  • 14 Salmi A, Tukiainen E, Harma M. A prospective study of chages in muscle dimensions following free-muscle transfer measured by ultrasound and CT scanning.  Plast Reconstr Surg . 1996;  97 1443-50
    PubMedSearch in Google Scholar
  • 15 Urken M L, Biller H F. A new bilobed design for the sensate radial forearm flap to preserve tongue mobility following significant glossectomy.  Arch Otolaryngol Head Neck Surg . 1994;  120 26-31
    CrossrefPubMedSearch in Google Scholar