Five-Year Single-Center Experience with Free Anterolateral Thigh Flaps for Head and Neck Oncologic Reconstruction
4th International Microsurgery Meeting Izmir, İzmir, Turkey, 26 - 28 September 2025, pp.12-17, (Full Text)
- Publication Type: Conference Paper / Full Text
- City: İzmir
- Country: Turkey
- Page Numbers: pp.12-17
- Bursa Uludag University Affiliated: Yes
Abstract
Introduction: Head and neck cancer resections often result in extensive tissue defects requiring complex reconstruction to restore function and aesthetics. Microvascular free flaps represent the gold standard, with the anterolateral thigh (ALT) flap being one of the most frequently used options due to its long pedicle, large skin paddle, low donor-site morbidity, and versatility. This study aimed to evaluate the epidemiologic characteristics, surgical details, and complications of free ALT flap reconstructions performed in our clinic and to compare the outcomes with current literature.
Materials and Methods: Between January 2019 and January 2025, a total of 41 patients who underwent head and neck reconstruction with free ALT flaps at Uludağ University Plastic Surgery Department were retrospectively analyzed. Demographic data, tumor localization, flap characteristics, recipient vessels, and postoperative complications were recorded and evaluated.
Results: The mean patient age was 61.2 ± 13.5 years; 68.3% were male. The most common pathology was squamous cell carcinoma (87.8%). Primary tumor sites included the gingivobuccal sulcus (n=9), retromolar trigone (n=8), and tongue (n=8). Mean flap size was 17.2 × 9.9 cm. The superior thyroid artery (56.1%) and internal jugular vein (68.3%) were the most frequently used recipient vessels. The overall complication rate was 43.9%, with wound dehiscence (14.6%) and hematoma (9.8%) being most common. Total flap survival rate was 90.2%, and 41.5% of patients required postoperative intensive care.
Conclusion: Free ALT flap reconstruction remains a reliable and versatile option for head and neck defects, providing acceptable complication rates and favorable survival outcomes. Advances such as preoperative CT angiography and intraoperative indocyanine green angiography have further improved flap viability. Successful outcomes depend on multidisciplinary collaboration, appropriate patient selection, and meticulous perioperative management.