Thinned anterolateral thigh cutaneous flap and radial fasciocutaneous forearm flap for reconstruction of oral defects: Comparison of donor site morbidity

Purpose: The thinned anterolateral thigh flap (tALT) has been utilized in clinical applications for soft tissue reconstruction. This flap has many advantages: no major artery is sacrificed; functional and esthetic results are often good. The purpose of this study is to investigate the esthetic outcome of the donor site after reconstruction of oral defects with tALT compared to the radial fasciocutaneous forearm flap (RFFF). Patients and Methods: Between January 2003 and December 2005, 42 patients affected by oral squamous cell carcinoma (27 males, 15 females; age range: 34-82 years, mean age, 61.4 years) received microsurgical reconstruction. We treated 17 patients with RFFF and 25 cases with tALT. Results: The RFFF group showed a success rate of 94.2% with only 1 total flap loss due to not reversible venous trombosis. In the tALT group we accomplished a 100% flap survival. Functional results at donor site in the RFFF group showed a persistent forearm movement impairment in about 30% of cases and sensitivity alterations in skin graft area in 75% of patients; in the tALT group we noticed only a transitory gait impairment in 1 patient; no clinical signs of circulatory disturbance were observed and no sensory disturbance of the thigh was reported. Conclusions: in our experience, we found the thinned ALT coutaneous flap the ideal soft tissue flap in oral reconstruction. This flap presents functional results at the receiving site with the additional advantage of minimal donor-site morbidity and a high level of patient satisfaction. (C) 2008 American Association of Oral and Maxillofacial Surgeons.