Maxillary reconstruction using anterolateral thigh flap and bone grafts

Abstract

The good results obtained using this technique encourage the choice of the association of anterolateral thigh and bone grafts for reconstructing maxillary complex defects.

The free anterolateral thigh musculocutaneous flap for head and neck reconstruction: One surgeon's experience in 92 cases

“…Wong et al 18 described in 2009 a technical note for the ALT musculocutaneous flap harvesting, underlining the importance of musculocutaneous perforators identification and preservation at the beginning of the dissection that has to be performed opening the intermuscular septum and unroofing the musculocutaneous perforators. We recently described the use of the free ALT musculocutaneous flap and bone grafts association for maxillary reconstruction; 19 however, as far as we know, other articles dedicated specifically to free ALT musculocutaneous flap patients series were published only in the last year and only in Chinese literature. Xia et al 20 reported their experience with ALT musculocutaneous flap for tongue and mouth floor reconstruction in 14 cases, while Liu et al 21 reported a series of 109 free ALT musculocutaneous flaps for reconstruction of soft tissue defects following en block resection of tongue cancer.…”

A systematic review of anterolateral thigh flap donor site morbidity

“…T he anterolateral thigh (ALT) flap, first described as a septocutaneous perforator-based flap by Song et al (1) in 1984, has recently gained popularity and has become an important option for reconstruction of multiple anatomical locations such as the head and neck (3)(4)(5)(6)(7)9,10,(12)(13)(14)16,(18)(19)(20)(21)(22)(23)(25)(26)(27)(28)(29)(30)32,34,36,38,39,(41)(42)(43), upper (15)(16)(17)(18)(19)26,32,35,37,38,42) and lower (8,(16)(17)(18)(19)22,24,…”

Reconstruction of the midface and maxilla

“…Other authors have shown the utility of the combination of bone grafts and rectus abdominis or latissimus dorsi free flaps. Bianchi et al [31] described the use of a myocutaneous anterolateral thigh free flap combined with nonvascularized iliac crest or calvarial bone grafts for Brown class 3 defects in a series of eight patients. In all cases, the bone grafts were draped in revascularized muscle and fascia with the skin paddle folded to reline the oral cavity.…”

“…A variety of donor sites providing soft tissue only or soft tissue with bone have been described in the literature, including the radial forearm [14][15][16][17][18], rectus abdominis [19,20], fibula [21][22][23][24], scapular [25][26][27], iliac crest [28,29], and anterolateral thigh [30,31] systems of free flaps. In all cases of midfacial reconstruction, the individual characteristics of the defect and the patient will guide which type of reconstruction is undertaken.…”

“…Multiple authors describe the use of soft tissue only flaps with bone grafts to reconstruct complex midfacial defects [31,33,34]. Coleman [33] discusses at length the rationale for use of free vascularized soft tissue flaps with primary or secondary nonvascualrized bone grafting to address the maxillary skeleton.…”