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. 2023 Jun;75(2):649-653.
doi: 10.1007/s12070-022-03416-3. Epub 2022 Dec 29.

Functional Reconstruction of Through and Through Cheek Defect with Free Composite Bi-pedalled Anterolateral Thigh Flap

Prashant Moon  1 , Jaykumar V Patel  2 , Girish Mishra  2 , Riddhi Trivedi  3 , Priyank Katwala  1   4
Affiliations

Functional Reconstruction of Through and Through Cheek Defect with Free Composite Bi-pedalled Anterolateral Thigh Flap

Prashant Moon et al. Indian J Otolaryngol Head Neck Surg. 2023 Jun.

Abstract

Extensive composite defects involving the lip and cheek present difficult reconstructive challenges in view of functional recovery like oral competence, articulation, speech and mastication. This study presents our results of reconstructing through and through cheek defect with the use of free anterolateral thigh (ALT) flaps. All the patients with carcinoma of buccal mucosa and cheek who underwent through and through cheek resection and reconstructed with free composite pedalled anterolateral thigh flap between March 2019 to March 2020 were included in the study. We have assessed the post-operative functional outcome using University of Washington Quality of Life Questionnaire at the end of 12 months duration. We have excluded lost to follow-up and flap failure patients. Fifty patients were matched our inclusion criteria. Mean age was 43 years. Male to female ratio was 4.6:1. Stage 3 disease was in 8 patients and stage 4 disease was in 42 patients. Average size of the flap required was 15 × 7.5 cm, maximum was 24 × 11 cm. Oral competence was good in 74% patients. 80% patients were able to take semisolid diet, 8% were on liquid diet and 12% were dependent on RT feed. Average physical function (70.47 ± 19.09), social-emotional sub-score (81.72 ± 16.63) and composite scores (76.09 ± 17.86) were good and within acceptable range. Chewing (53 ± 29.29) and swallowing (64 ± 21.57) scored poorly among 12 domains. For extensive through and through cheek defects bipedelled ALT provides good functional outcome. In view of advance disease status extensive resection would be responsible for bone and mucosal loss affecting chewing and swallowing.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-022-03416-3.

Keywords: Anterolateral thigh flap; Oral reconstruction; Quality of life; Through and through cheek defect.

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Conflict of interest statement

Conflict of interestThere is no conflict of interest of any of author.

Figures

Fig. 1
Fig. 1
Showing pre-operative picture of patient with Left gingivobuccal complex carcinoma
Fig. 2
Fig. 2
Showing intraoperative picture of the defect to be reconstructed following resection of carcinoma
Fig. 3
Fig. 3
Showing Marking of Anterolateral thigh flap for reconstruction
Fig. 4
Fig. 4
Post operative picture of patient with reconstructed composite bipeddaled anterolateral thigh flap
See this image and copyright information in PMC

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