Versatility of the free anterolateral thigh flap for reconstruction of head and neck defects

Yoshihiro Kimata, Kiyotaka Uchiyama, Satoshi Ebihara, Takashi Yoshizumi, Masao Asai, Masahisa Saikawa, Ryuichi Hayashi, Yoko Jitsuiki, Kazuhiko Majima, Waichiro Ohyama, Tatsumasa Haneda, Takashi Nakatsuka, Kiyonori Harii

Research output: Contribution to journalArticlepeer-review

181 Citations (Scopus)


Objective: The anterolateral thigh flap has many advantages in head and neck reconstruction. However, it has not yet come into widespread use because of the anatomic variations of its perforators. Herein, we describe a safe operative technique related to the patterns of the perforators and discuss its wide versatility. A national cancer center hospital. Patients: Thirty- eight anterolateral thigh flaps were transferred. Confirmation and dissection of the flap pedicle were simultaneously performed with tumor resection. The design and elevation of the flap were carried out immediately after the tumor resection was completed. Results: From the study of the anatomic variations of the perforators, septocutaneous patterns were recognized in 10 cases (26.3%) and musculocutaneous patterns in 28 cases (73.7%). All flaps were easily and safely elevated with our techniques. Thirty-six flaps survived. Partial necrosis was noted owing to excessive thinning procedure in one patient and total necrosis was noted owing to venous thrombosis at the anastomosis part in another patient. Conclusions: We found that the anterolateral thigh flap has numerous advantages. It is possible to perform the flap elevation arid the tumor resection simultaneously. The flap is generally thin and is suitable for reconstruction of intraoral defects. Combined flaps with neighboring tissues and other, distant flaps can be used. Furthermore, since our technique minimizes the problems of confirmation and dissection of the perforators, we conclude that this flap can be successfully used to repair a variety of large defects of the head and neck.

Original languageEnglish
Pages (from-to)1325-1331
Number of pages7
JournalArchives of Otolaryngology - Head and Neck Surgery
Issue number12
Publication statusPublished - Dec 1997
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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