Event Title

Anterolateral Thigh Osteomyocutaneous Flap Reconstruction Following Unilateral Composite Resection with Hemimandibulectomy

Location

Breakout Session B - Health Sciences II

CASB 101

Start Date

8-4-2022 3:45 PM

End Date

8-4-2022 4:00 PM

Description

Recent literature has shown that the anterolateral thigh (ALT) free flap, a work horse of head and neck reconstruction, can be modified to incorporate the femur. This free flap is known as the anterolateral thigh osteomyocutaneous (ALTO) flap. The ALTO flap shares shares many of the advantages of the ALT flap that have contributed to the ALT flap’s popularity, such as the large amount of soft tissue available for harvest, consistent anatomy, and feasibility for the two-team approach of simultaneous resection and flap harvest. We report a case where the ALTO flap was selected for reconstruction since the reconstruction requiried an osseous component and alarge amount of soft tissue. The patient had a complicated medical history making him a poor candidate for a double flap system. Postoperatively, the patient had failure of 1 of 3 ALT perforators requiring surgical debridement of nonviable soft tissue and a pectoralis flap on postoperative day 12. The remaining ALTO and pectoralis flaps remain viable, and the patient has had no further complications. This case and available literature demonstrate that the ALTO flap is a unique option ideal for reconstructions involving large defects with an osseous component, especially in patients who cannot undergo the more typical fibula, scapular system, or double free flap reconstruction.

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Apr 8th, 3:45 PM Apr 8th, 4:00 PM

Anterolateral Thigh Osteomyocutaneous Flap Reconstruction Following Unilateral Composite Resection with Hemimandibulectomy

Breakout Session B - Health Sciences II

CASB 101

Recent literature has shown that the anterolateral thigh (ALT) free flap, a work horse of head and neck reconstruction, can be modified to incorporate the femur. This free flap is known as the anterolateral thigh osteomyocutaneous (ALTO) flap. The ALTO flap shares shares many of the advantages of the ALT flap that have contributed to the ALT flap’s popularity, such as the large amount of soft tissue available for harvest, consistent anatomy, and feasibility for the two-team approach of simultaneous resection and flap harvest. We report a case where the ALTO flap was selected for reconstruction since the reconstruction requiried an osseous component and alarge amount of soft tissue. The patient had a complicated medical history making him a poor candidate for a double flap system. Postoperatively, the patient had failure of 1 of 3 ALT perforators requiring surgical debridement of nonviable soft tissue and a pectoralis flap on postoperative day 12. The remaining ALTO and pectoralis flaps remain viable, and the patient has had no further complications. This case and available literature demonstrate that the ALTO flap is a unique option ideal for reconstructions involving large defects with an osseous component, especially in patients who cannot undergo the more typical fibula, scapular system, or double free flap reconstruction.