Adipofascial anterolateral thigh free flap in head and neck reconstruction: a case series

BACKGROUND: The adipofascial anterolateral thigh (AF-ALT) free flap represents a versatile technique in head and neck reconstructions, with its applications increasingly broadening. The objective was to detail the novel utilization of the AF-ALT flap in orbital and skull base reconstruction, along with salvage laryngectomy onlay in our case series. METHOD: We conducted a retrospective analysis at Roswell Park Comprehensive Cancer Center, spanning from July 2019 to June 2023, focusing on patient demographics and reconstructive parameters data. RESULTS: The AF-ALT flap was successfully employed in eight patients (average age 59, body mass index [BMI] 32.0) to repair various defects. Noteworthy outcomes were observed in skull base reconstructions, with no flap failures or major complications over an average 12-month follow-up. Donor sites typically healed well with minimal interventions. CONCLUSION: Our series is the first to report the AF-ALT flap's efficacy in anterior skull base and orbital reconstructions, demonstrating an additional innovation in complex head and neck surgeries.

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In a retrospective series of eight patients, the adipofascial anterolateral thigh free flap was used for various head and neck defects, including orbital and skull base reconstructions, with skull base repairs showing no flap failures or major complications during an average 12-month follow-up.

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