Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (1): 87-91.doi: 10.6040/j.issn.1673-3770.0.2022.337

• Review • Previous Articles     Next Articles

The application of adipofascial anterolateral thigh flap in reconstruction of the head and neck

LI Baofei, AINIWAER·Mailudan, YANG Xin, CHEN Fei   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China
  • Published:2024-01-12

PDF (PC)

296

Abstract: The complex defects that result from surgery for some head and neck malignancies present a challenge for surgeons. The free anterolateral thigh flap, forearm flap, and free fibular flaps are frequently used in these procedures.Recently, the free adipofascial anterolateral thigh flap has also been widely used in the reconstruction of the head and neck. This article reviews the recent literature, summarizes applied anatomical characteristics, and discusses the current applications of the adipofascial anterolateral thigh flap in various subunits of the head and neck. Indications, advantages, and disadvantages of the use of this flap are also included.

Key words: Free adipofascial anterolateral thigh flap, Free anterolateral thigh flap, Defects in head and neck, Reconstruction, Surgical flaps

CLC Number: 

  • R739.91
[1] 刘绍严, 鄢丹桂. 头颈肿瘤术后缺损修复的现状与展望[J]. 中国耳鼻咽喉颅底外科杂志, 2020, 26(3): 231-234. doi: 10.11798 /j.issn.1007-1520.202003001
[2] Tong XJ, Tang ZG, Shan ZF, et al. The anterolateral thigh flap for soft tissue reconstruction in patients with tongue squamous cell carcinoma[J]. World J Surg Oncol, 2016, 14(1): 213. doi: 10.1186/s12957-016-0972-8
[3] Kekatpure VD, Trivedi NP, Shetkar G, et al. Single perforator based anterolateral thigh flap for reconstruction of large composite defects of oral cavity[J]. Oral Oncol, 2011, 47(6): 517-21. doi: 10.1016/j.oraloncology.2011.03.023
[4] Shimizu F, Uehara M, Oatari M, et al. Three-dimensional visualization of the human face using DICOM data and its application to facial contouring surgery using free anterolateral thigh flap transfer[J]. J Plast Reconstr Aesthet Surg, 2016, 69(1): e1-e4. doi:10.1016/j.bjps.2015.07.025
[5] Loreti A, Abate O, Arelli F, et al. Reconstruction of hypopharyngeal defects with anterolateral thigh free flap: a single-center retrospective analysis [J]. Am J Otolaryngol, 2022, 43(5): 103542. doi:10.1016/j.amjoto.2022.103542
[6] Ranganath K, Jalisi SM, Naples JG, et al. Comparing outcomes of radial forearm free flaps and anterolateral thigh free flaps in oral cavity reconstruction: a systematic review and meta-analysis[J]. Oral Oncol, 2022, 135:106214. doi: 10.1016/j.oraloncology.2022.106214
[7] Hsiao HT, Leu YS, Liu CJ, et al. Radial forearm versus anterolateral thigh flap reconstruction after hemiglossectomy: functional assessment of swallowing and speech[J]. J Reconstr Microsurg, 2008, 24(2):85-88. doi: 10.1055/s-2008-1076097
[8] Agostini V, Dini M, Mori A, et al. Adipofascial anterolateral thigh free flap for tongue repair[J]. Br J Plast Surg, 2003, 56(6): 614-618. doi:10.1016/s0007-1226(03)00204-2
[9] 侯春林, 顾玉东. 皮瓣外科学[M]. 上海: 上海科学技术出版社, 2006
[10] Gholami M, Shaban B, Hejazi A, et al. Anatomical variations of anterolateral thigh flap: a fresh cadaver dissection study[J]. World J Plast Surg, 2021, 10(3): 18-24. doi:10.29252/wjps.10.3.18
[11] 张启旭, 乔群, 陈光宇, 等. 股前外侧脂肪筋膜瓣血管三维结构的研究及应用[J]. 中华整形外科杂志, 2002, 18(4): 200-203. doi: 10.3760/j.issn: 1009-4598.2002.04.002 ZHANG Qixu, QIAO Qun, CHEN Guangyu, et al. Three-dimensional observation of the vasculature in the anterolateral thigh adi pofascial flap and its clinical applications[J]. Chinese Journal of Plastic Surgery, 2002, 18(4): 200-203. doi: 10.3760/j.issn:1009-4598.2002.04.002
[12] Nakajima H, Minabe T, Imanishi N. Three-dimensional analysis and classification of arteries in the skin and subcutaneous adipofascial tissue by computer graphics imaging[J]. Plast Reconstr Surg, 1998, 102(3): 748-760. doi:10.1097/00006534-199809030-00020
[13] Agostini T, Agostini V. Adipofascial versus fasciocutaneous anterolateral thigh flap in oral cavity reconstruction. Focus on the vascular supply[J]. J Plast Reconstr Aesthet Surg, 2009, 62(12): e633-e634. doi:10.1016/j.bjps.2008.10.003
[14] Revenaugh PC, Haffey TM, Seth R, et al. Anterolateral thigh adipofascial flap in mucosal reconstruction[J]. JAMA Facial Plast Surg, 2014, 16(6): 395-399. doi:10.1001/jamafacial.2014.447
[15] Shaw RJ, Batstone MD, Blackburn TK, et al. The anterolateral thigh flap in head and neck reconstruction: “pearls and pitfalls”[J]. Br J Oral Maxillofac Surg, 2010, 48(1): 5-10. doi:10.1016/j.bjoms.2009.07.026
[16] Agostini T, Russo GL, Zhang YX, et al. Adipofascial anterolateral thigh flap safety: applications and complications[J]. Arch Plast Surg, 2013, 40(2): 91-96. doi:10.5999/aps.2013.40.2.91
[17] 陈健, 李暐. 带蒂组织瓣在头颈部肿瘤术后缺损修复重建中的应用研究进展[J]. 中国修复重建外科杂志, 2018, 32(3): 369-376. doi:10.7507/1002-1892.201710098 CHEN Jian, LI Wei. Research progress of pedicled flaps for defect repair and reconstruction after head and neck tumor resection[J]. China Industrial Economics, 2018, 32(3): 369-376. doi:10.7507/1002-1892.201710098
[18] 李亚楠. 上颌骨切除术后外科修复进展[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 113-117. doi:10.6040/j.issn.1673-3770.0.2020.326 LI Yanan. Advancements in surgical repair after maxillectomy[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 113-117. doi:10.6040/j.issn.1673-3770.0.2020.326
[19] 白艳霞, 闫利英, 张少强, 等. 异种脱细胞真皮基质修复膜在组织缺损修复中的应用[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(17): 1292-1295. doi: 10.13201/j.issn.1001-1781.2014.17.006 BAI Yanxia, YAN Liying, ZHANG Shaoqiang, et al. Application of xenogenic acellular dermal matrix repair membrane in tissue defect repair[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(17): 1292-1295. doi: 10.13201/j.issn.1001-1781.2014.17.006
[20] Wang XC, Qiao Q, Liu ZF, et al. Free anterolateral thigh adipofascial flap for hemifacial atrophy[J]. Ann Plast Surg, 2005, 55(6): 617-622. doi:10.1097/01.sap.0000189659.76694.e2
[21] 滕利, 吴国平, 张智勇, 等. 股前外侧脂肪筋膜瓣游离移植矫治半侧颜面萎缩[J]. 口腔颌面外科杂志, 2005, 15(1): 60-62. doi:10.3969/j.issn.1005-4979.2005.01.018 TENG Li, WU Guoping, ZHANG Zhiyong, et al. Correction of hemifacial atrophy using free anterolateral thigh adipofascial flap[J]. China Journal of Oral and Maxillofacial Surgery, 2005, 15(1): 60-62. doi:10.3969/j.issn.1005-4979.2005.01.018
[22] 张明子, 李之瑾, 李海瑞, 等. 游离股前外侧筋膜脂肪瓣联合人脱细胞异体真皮重塑半侧颜面萎缩畸形[J]. 中华医学美学美容杂志, 2022, 28(1): 22-25. doi:10.3760/cma.j.issn.1671-0290.2022.01.006 ZHANG Mingzi, LI Zhijin, LI Hairui, et al. Facial depression correction by using free anterolateral thigh adipofascial flap and human acellular dermal matrix[J]. Chinese Journal of Medical Aesthetics and Cosmetology, 2022, 28(1): 22-25. doi:10.3760/cma.j.issn.1671-0290.2022.01.006
[23] 高寿松. 股前外侧脂肪筋膜瓣游离移植修复面部凹陷的临床研究[D]. 北京: 中国协和医科大学, 2007
[24] Teng L, Jin XL, Wu GP, et al. Correction of hemifacial atrophy using free anterolateral thigh adipofascial flap[J]. J Plast Reconstr Aesthet Surg, 2010, 63(7): 1110-1116. doi:10.1016/j.bjps.2009.06.009
[25] 李小东. 股前外侧组织瓣在口腔颌面部组织缺损修复中的应用[D]. 西安: 第四军医大学, 2010
[26] Hanasono MM, Skoracki RJ, Silva AK, et al. Adipofascial perforator flaps for “aesthetic” head and neck reconstruction[J]. Head Neck, 2011, 33(10): 1513-1519. doi:10.1002/hed.21637
[27] Ouf MO, Zayid T, Elbatawy A, et al. Aesthetic restoration of severe hemifacial atrophy with free adipofacial antero lateral thigh flap followed by autologous fat grafting; optimizing result and long-term outcome[J]. J Craniofac Surg, 2021, 32(5): e413-e418. doi:10.1097/SCS.0000000000007171
[28] 明华伟, 何芸, 张兴安, 等. 股前外侧脂肪筋膜瓣游离移植修复面颊部严重凹陷畸形[J]. 中国美容整形外科杂志, 2019, 30(11): 674-677 MING Huawei, HE Yun, ZHANG Xingan, et al. The application of free anterolateral thigh adipofascial flap in the repair of severe facial depressed deformity[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2019, 30(11): 674-677
[29] Guelinckx PJ, Sinsel NK. Facial contour restoration in Barraquer-Simons syndrome using two free anterolateral thigh flaps[J]. Plast Reconstr Surg, 2000, 105(5): 1730-1736. doi:10.1097/00006534-200004050-00019
[30] Agostini T, Agostini V. Adipofascial anterolateral thigh free flap for hemifacial atrophy[J]. Acta Otorhinolaryngol Ital, 2009, 29(2): 103-107
[31] Agostini T, Agostini V. Further experience with adipofascial ALT flap for oral cavity reconstruction[J]. J Plast Reconstr Aesthet Surg, 2008, 61(10): 1164-1169. doi:10.1016/j.bjps.2008.03.038
[32] Kuo YR, Yeh MC, Shih HS, et al. Versatility of the anterolateral thigh flap with vascularized Fascia lata for reconstruction of complex soft-tissue defects: clinical experience and functional assessment of the donor site[J]. Plast Reconstr Surg, 2009, 124(1): 171-180. doi:10.1097/PRS.0b013e3181a80594
[33] Agostini T, Agostini V, Lazzeri D. Current roles of adipofascial anterolateral thigh flap in head and neck reconstructions[J]. Head Neck, 2011, 33(4): 595-596; authorreply 596-597. doi:10.1002/hed.21710
[34] 王友元. 颌下进路下颌骨劈开行舌鳞癌根治同期皮瓣修复的疗效观察[C] //中华口腔医学会口腔颌面-头颈肿瘤专业委员会.2019第一届全国口腔颌面-头颈肿瘤学术大会——聚合引领、协同发展论文汇编. 2019: 1. doi:10.26914/c.cnkihy.2019.081065
[35] 葛胜优. 股前外侧肌筋膜瓣与股前外侧皮瓣修复口腔癌组织缺损的疗效对比(附20例临床病例汇报)[D]. 青岛: 青岛大学, 2020
[36] Kekatpure VD, Hedne N, Chavre S, et al. Versatility of adipofascial anterolateral thigh flap for reconstruction of maxillary defects with infratemporal fossa extension[J]. Craniomaxillofac Trauma Reconstr, 2014, 7(3): 213-217. doi:10.1055/s-0034-1371973
[37] Coelho R, Ekberg T, Svensson M, et al. Reconstruction of late esophagus perforation after anterior cervical spine fusion with an adipofascial anterolateral thigh free flap: a case report[J]. Microsurgery, 2017, 37(6): 684-688. doi:10.1002/micr.30170
[38] Xu F, Deng D, Li BF, et al. Adipofascial anterolateral thigh free flap in hypopharyngeal and oropharyngeal reconstruction[J]. Microsurgery, 2022, 42(6): 586-592. doi:10.1002/micr.30863
[39] Driessen C, van Hout N, van Kuppenveld P, et al. Usefulness of a template-based anterolateral thigh flap for reconstruction of head and neck defects[J]. Microsurgery, 2020, 40(7): 776-782. doi:10.1002/micr.30637
[1] LIU Yuhong, BO Lin, LIU Xingang, SU Faren, MA Qifa. Pedicled superficial temporal fascia flap and local skin graft combined with cartilage transplantation effectively repair cartilage scaffold exposure in auricular reconstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(1): 9-12.
[2] LI Xiaoyu, ZHAO Danheng, LIU Ya, LIU Yang. Preliminary analysis of the position and related factors of titanium ossicular prostheses during mastoid and tympanic revision surgeries [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 1-5.
[3] ZHU Jun, NIE RuyaOverview,LI GuoyiGuidance. The advances in application of mastoid obliteration materials in mastoidectomy canal wall down with tympanoplasty [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(6): 111-116.
[4] ZHANG Lijun, XU Ran, LUO Jifang, LIU Guoqi, HE Qian, LI Wei, JIANG Zhenhua. Factors affecting flap neurosis and other postoperative flap-related complications after free-flap reconstruction of head and neck tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 86-90.
[5] WU Zebin,QIU Qianhui. Endoscopic surgery for skull base lesions in pediatric patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(3): 112-117.
[6] . The swallowing function recovery study on tongue flap after horizontal hemilaryngectomy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(5): 127-131.
[7] DENG Di, LIU Jun, LI Linke, WANG Ji, LIU Jifeng, LV Dan, WANG Haiyang, GAN Weigang, WANG Jun, LI Bo, CHEN Fei. Two-stage reconstructive strategy using a flap for non-circumferential tracheal defects [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 52-57.
[8] SU Faren, LIU Yuhong, BO Lin, LIU Xingang. A negative pressure drainage device for dermal dilatation of microtia in the second phase of auricular reconstruction surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 125-128.
[9] Zhili WANG,Zhe CHEN,Fangyu LIN,Yongchuan CHAI,Zhaoyan WANG. Facial nerve reconstruction in the parotid area under a variety of circumstances [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 15-19.
[10] BO Lin, LIU Xingang, LIU Yuhong, SU Faren. Application of expanded skin flaps and fascial flaps(the two flaps method)in ear reconstruction for patients with microtiag [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 49-51.
[11] WANG Panpan. Effects of a quality control circle-based discharge plan on rehabilitation after ear deformity reconstruction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 165-168.
[12] CHEN Ying, LI Yuanbin. Progress in the treatment of congenital cataract [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 143-148.
[13] ZHENG Chaopan, MA Lingguo, ZHOU Jingchun, YAN Min, MAI Jiahao, ZHONG Shiru, ZENG Xiaoyan. Experimental study on the repair of canine laryngeal defect by nickel-titanium alloy stent and double-pedicled fascial flap [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 22-25.
[14] L(¨overU)Huiyan, ZHANG Xiuchuan, ZHOU Cunying, LI Bo, LI Weibing. Application of autologous orbital periosteum combined with amniotic membrane in reconstruction of eyelid defects [J]. J Otolaryngol Ophthalmol Shandong Univ, 2018, 32(4): 84-86.
[15] WU Qingwei, ZHAO Yingying, WANG Peihua, WANG Zhongying, CHEN Dong. Curative effect of delayed local flap repair on defects of the nasal tip and dorsum in nasal emergency trauma [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(1): 14-17.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd