Versatility of free anterolateral thigh flap for head and neck reconstruction

Background and objective: The management of patients with head and neck defects from trauma and tumors (malignant and benign) is challenging, and the choice for reconstructive plan is most significant for better outcome regarding function (such as swallowing and speech), and aesthetic appearance. The anterolateral thigh free flap is one of the commonly used free flaps for reconstruction of complex wounds specially after oncosurgical resection. The objective of the study is to assess the versatility of anterolateral thigh free flap in reconstruction of complex wounds at head and neck. Methods: Our retrospective study was carried out within five years from 2018 to 2022, in Erbil (the capital of Kurdistan Region, Iraq) at Maryamana and PAR private hospitals. We had ten patients with head and neck defects, and all the operations had been done under general anesthesia, five of them were myo-cutaneous and five were fascio-cutaneous flaps, they remained for about a week at the hospital for follow up and the antiplatelet (aspirin) with the anticoagulant (low molecular weight heparin) had been prescribed to all of them. Results: Ten patients were included in the study, their mean age (SD) was 54.6 (21.1) years, the age range was 10-84 years, and 60% of them were males. The flap sites were the maxilla (40%), ear and temple (20%), in addition to the other sites. The commonest cause was maxillary cancer in 40% of the patients. All the flaps survived, and only one patient (10%) developed partial skin loss at the recipient site. Conclusion: The anterolateral free flap has got many advantages and its viability and versatility is very high in management of complex wound defect in different sites of the body and to avoid risks it’s better to postpone thinning of the flap at the initial operation. Keywords: Anterolateral free flap; Complex defect; Head and neck; Microsurgery.