Abstract
The anterolateral thigh free flap (ALTFF) has become the favourable fasciocutaneous flap for reconstruction of laryngo-pharyngoesophagectomy (LPO) defects. Reconstruction of these defects can be challenging. We report our experience with a new flap design based on the traditional ALTFF template for single-stage reconstruction of circumferential LPO defects with anterior neck skin deficits in previously irradiated patients. The design uses the traditional tubed skin island to create the neopharynx and also utilises the natural dog-ears from the thigh as a second vascularised skin island that can be used to fill dead space or externalised to resurface the neck. This addresses the issues of monitoring the internal skin paddle and also of replacing anterior neck skin deficits with a single flap.
Level of Evidence: Level V, therapeutic study.
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References
Yu P, Robb GL (2005) Pharyngoesophageal reconstruction with the anterolateral thigh flap: a clinical and functional outcomes study. Plast Reconstr Surg 116:1845–1855
Wei FC, Jain V, Celik N et al (2002) Have we found an ideal soft tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109:2219–2226
Yu P (2005) One stage reconstruction of complex pharyngoesophageal, tracheal and anterior neck defects. Plast Reconstr Surg 116:949–956
Spyropoulou GA, Lin PY, Chien CY, Kuo YR, Jeng SF (2011) Reconstruction of the hypo pharynx with the anterolateral thigh flap: defect classification, method, tips and outcomes. Plast Reconstr Surg 127:161–172
Yu P, Hanasono MM, Skoracki RJ et al (2010) Pharyngoesophageal reconstruction with the anterolateral thigh flap after total laryngopharyngectomy. Cancer 116:1718–1724
Sagar B, Marres HA, Hartman EH (2010) Hypopharyngeal reconstruction with an anterolateral thigh flap after laryngopharyngeal resection: results of a retrospective study on 20 patients. J Plast, Reconstr Aesthet Surg 63:970–975
Lewin JS, Barringer DA, May AH et al (2005) Functional outcomes after circumferential pharyngoesophageal reconstruction. Laryngoscope 115:1266–1271
Yu P (2004) Characteristics of the anterolateral thigh flap in a Western population and its application in head and neck reconstruction. Head Neck 26:759–769
Song YG, Song YL (1984) The free thigh flap: a new free flap concept based in the septocutaneous artery. Br J Plast Surg 37:149–159
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Ania Olympia Smialkowski and Kevin Ho declare that they have no conflict of interest.
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Smialkowski, A.O., Ho, K. Modification of the anterolateral thigh free flap design for reconstruction after laryngo-pharyngoesophagectomy. Eur J Plast Surg 39, 139–142 (2016). https://doi.org/10.1007/s00238-015-1074-5
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DOI: https://doi.org/10.1007/s00238-015-1074-5