OBJECTIVETo explore the anterolateral thigh (ALT) free flap in which the donor site is less noticeable and the morbidity is minimal for the reconstruction of head and neck defect.

METHODSA retrospective review was performed of 8 ALT flaps reconstructions for head and neck tumor ablation defects between Dec. 2003 and May 2005. Recipient sites were subdivided into pharyngeal wall (n = 3), oral tongue (n = 2), buccal mucosa (n = 1), base of tongue (n = 1) and skull base (n = 1). The operative technique of ALT flap was described.

RESULTSAll 8 free flaps survived. No complication was observed in the donor site, like wound dehiscence, weakness of the legs. The anatomy of the perforators were recognized as musculocutaneous pattern in all 8 cases. The size of the flap ranged from (4 to approximately 8) cm x (5 to approximately 10) cm. The average time of operation was 7 hours with a range of 5 to 10 hours. The average time cost for ATL flap harvest was 80 minutes with a range of 65 to 115 minutes.

CONCLUSIONSFree ALT flap is a reliable reconstruction technique for head and neck surgical defects. Because of the minimum donor site morbidity and the concealed site, this flap is the ideal choice for reconstruction of head and neck surgical defects.