Total nasal reconstruction with pre‐laminated, super‐thin anterolateral thigh flap: A case report

Bali, Zülfükar Ulaş; Karatan, Berrak; Parspancı, Aziz; Tuluy, Yavuz; Keçeci, Yavuz; Yoleri, Levent

doi:10.1002/micr.30748

Cited by 10 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While the superthin flaps have been used especially for extremities (Diamond et al, 2018) and other head and neck (Bali, Karatan, et al, 2021; Gur et al, 2022) reconstructions, there is still no consensus on what to do for pharyngoesophageal reconstructions in cases with bulky ALT. Some authors preferred or suggested to use RFFF when the ALT was bulky in overweight patients (Nagel & Hayden, 2014; Sharaf et al, 2017) for pharyngoesophageal reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…However, the potential risk is perfusion problems when thinning procedure is chosen in the literature. On the other hand, it has been used for different kind of defects of the body successfully in the literature (Bali, Ozkan, et al, 2021) While the superthin flaps have used especially for extremities (Diamond et al, 2018) and other head and neck (Bali, Karatan, et al, 2021;Gur et al, 2022) reconstructions, there is still no consensus on what to do for pharyngoesophageal reconstructions in cases with bulky ALT. Some authors preferred or suggested to use RFFF when the ALT was bulky in overweight patients (Nagel & Hayden, 2014;Sharaf et al, 2017) for pharyngoesophageal reconstruction.…”

Section: Case Reportsmentioning

confidence: 99%

See 1 more Smart Citation

The use of chimeric‐superthin anterolateral thigh flap in reconstruction of laryngopharyngoesophagectomy defects of hypopharyngeal cancer

et al. 2023

View full text Add to dashboard Cite

IntroductionDue to 3D defects after resection of hypopharyngeal cancers, free flaps have become as first option for reconstruction and the anterolateral thigh flap (ALT) has been chosen frequently for soft tissue defects. Chimerization of the skin island of the ALT is also possible which can result in reconstruction of multiple defects simultaneously and monitorization of buried flaps. However, ALT can be bulky in some patients. The superthin ALT is well established by some authors especially for extremities but there is no study about the use of this modification in pharyngoesophageal defects. We present our experience of using chimeric‐superthin ALT for pharyngoesophageal reconstructions.Patients and MethodsBetween 2019 and 2022, six patients (one female and five male) underwent hypopharyngeal tumor resection and experienced chimeric‐superthin ALT flap reconstructions. Patients' ages were ranged between 53 and 71 (mean: 64) years old. The type of tumor was squamous cell carcinoma (SCC) for all patients. Three patients had total and three patients had 75% of pharyngoesophageal defects. Defect size was between 10 × 7 cm and 12 × 8.5 cm (mean: 87.08 cm2). All flaps were harvested as 5 mm thickness with two skin perforators. All flaps were divided into two individual skin islands as chimeric fashion. One of the skin islands was used for esophageal reconstruction and the other was used for both flap monitorization and tensionless closure of anterior neck skin.ResultsTotal flap size was between 18 × 9 cm and 21 × 11 cm (mean: 200 cm2). In two patients, anastomoses were performed to pectoral branch of thoracoacromial vessels. Neck vessels were chosen as recipient for remaining patients. Wound dehiscence occurred in two patients between the neck skin and monitor island and was re‐sutured without any problems. There was no partial or total flap necrosis and all flaps survived. The follow up period was between 4 and 9 months (mean: 5.6). All patients had a successful functional outcome as swallowing.ConclusionThe superthin‐chimeric ALT flap is a useful option when classical ALT is bulky in defects of hypopharyngeal cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Case Reportsmentioning

confidence: 99%

The use of chimeric‐superthin anterolateral thigh flap in reconstruction of laryngopharyngoesophagectomy defects of hypopharyngeal cancer

et al. 2023

View full text Add to dashboard Cite

show abstract

“…We feel that the ALT flap which is primarily raised in the superficial fascia plane is the fastest and safest option for obtaining a thin flap. In head and neck reconstructions, the super‐thin ALT flap harvested in the superficial fascia plane has been described for lower lip reconstructions (Bali, Ozkan, et al, 2021) and total nasal reconstruction (Bali, Karatan, et al, 2021). However, not much literature is available on its use for tongue and buccal mucosa reconstructions.…”

Section: Discussionmentioning

confidence: 99%

Use of super‐thin anterolateral thigh flap in intra‐oral reconstruction of soft tissue defects

Dave,

Priyadarshini,

Wadhwani

et al. 2023

Microsurgery

View full text Add to dashboard Cite

BackgroundTraditional sub‐fascial anterolateral thigh (ALT) flaps are bulky and often give unsatisfactory outcomes in several head and neck reconstructions where thin pliable flaps are required. As a result, despite high incidence of donor site complications, radial forearm flap is still commonly used for tongue, buccal mucosa and lip defects where a traditional ALT flap would be too bulky. The objective of this report was to evaluate the usefulness of super‐thin ALT flap as an alternative to radial forearm flap for intra‐oral reconstruction.Patients and methodsRetrospective evaluation was done of all head and neck reconstructions performed by a single surgeon between December 2021 and May 2022. Twenty‐two patients who had undergone super‐thin ALT flaps for intra‐oral reconstruction of soft tissue defects were included in the report. These included buccal mucosa (n = 11), tongue (n = 8), and buccal mucosa with neck skin defects (n = 3). All patients had undergone wide excision of oral squamous cell carcinoma, and had history of chewing tobacco. Average age of patients was 54 years, 16 were males and 6 were females. Mean BMI of the patients was 25.2 kg/m2 (Range: 20.5–31.0 kg/m2). Super‐thin ALT flap was elevated in the plane of superficial fascia of the thigh, thus leaving behind the deeper fat. The flaps were shaped as per the measurements obtained from the specimen as well as the defect and intra‐oral inset was done prior to vascular anastomosis.ResultsMean flap dimension was 8.3 × 6.7 cm (range: 6 × 5 to 20 × 7 cm). Mean flap thickness was 9 mm (range: 4–20 mm). Mean flap elevation time was 70.9 min (Range: 48–105 min). None of the flaps needed a re‐exploration. All flaps survived completely. One patient had surgical site infection at the flap donor site which was managed conservatively. Mean follow up was 5 months (range: 3–10 months). All patients were able to take soft oral diet at the last follow up.ConclusionsSuper‐thin ALT flaps raised in superficial fascia plane are reliable and provide thin, pliable tissue for head and neck reconstruction. Unlike other thin flaps, these are not limited by donor site morbidity and flap dimension.

show abstract

“…The latter solution provides ample and versatile tissue for mucosal lining and skin coverage1 [ 3 ]. The ALT flap has many advantages, such as a considerable pedicle length, a large and reliable skin paddle, easy customization of flap size, use of the chimeric fashion, less morbidity of the donor site [ 6 , 7 ]. The main disadvantage of this flap is that it is very thick, 2–4 cm, which makes it difficult to reconstruct a three-dimensional structure and less noticeable in this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…The main disadvantage of this flap is that it is very thick, 2–4 cm, which makes it difficult to reconstruct a three-dimensional structure and less noticeable in this procedure. Total nose reconstruction can be performed in one or two stages as the pre-laminated or super-thin ALT flap [ [6] , [7] , [8] ]. However, this obstacle can be solved by the thinning procedure.…”

Section: Discussionmentioning

confidence: 99%

Facial acid postburn reconstruction with multiple contemporary procedures in a stepwise fashion

Sơn,

Duy,

Nghĩa

et al. 2023

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Total nasal reconstruction with pre‐laminated, super‐thin anterolateral thigh flap: A case report

Cited by 10 publications

References 10 publications

The use of chimeric‐superthin anterolateral thigh flap in reconstruction of laryngopharyngoesophagectomy defects of hypopharyngeal cancer

The use of chimeric‐superthin anterolateral thigh flap in reconstruction of laryngopharyngoesophagectomy defects of hypopharyngeal cancer

Use of super‐thin anterolateral thigh flap in intra‐oral reconstruction of soft tissue defects

Facial acid postburn reconstruction with multiple contemporary procedures in a stepwise fashion

Contact Info

Product

Resources

About