J Korean Assoc Oral Maxillofac Surg.  2024 Dec;50(6):361-366. 10.5125/jkaoms.2024.50.6.361.

Chimeric anterolateral thigh flap for reconstruction of complex defects in oral cancer: a report of three cases

• Kim HS
• Ahn KM
• Lee JH

• KMID: 2563965
• DOI: http://doi.org/10.5125/jkaoms.2024.50.6.361

Abstract

It is crucial to reconstruct extensive soft tissue defects following oral cancer resection to restore both function and aesthetics. Single anterolateral thigh flaps may not suffice for large defects. This report highlights the use of chimeric flaps, which feature multiple paddles with individual perforators, to reconstruct large intraoral and extraoral defects, adapting to wide defects, and covering areas with extensive tissue damage. This case series demonstrates the adaptability and effectiveness of chimeric flaps, demonstrating them to be a superior option for satisfactory healing and functional outcomes in reconstruction of complex defects.

Keyword

Head and neck neoplasms; Anterolateral thigh flap; Anterolateral thigh flap; Reconstructive surgical procedures; Complex defects

Figure

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  Fig. 1 A, B. A large oral mass with skin involvement in the patient’s right mandible.

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  Fig. 2 A. Resection of the tumor in the right mandible and right supraomohyoid neck dissection were performed. B. A chimeric flap with a single pedicle containing two skin paddles, each having its own perforator, was harvested.

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  Fig. 3 A, B. Clinical examination showed no signs of recurrence at the primary site, extraorally or intraorally.

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  Fig. 4 A, B. A chimeric flap with two narrow skin paddles was harvested from the left anterolateral thigh (ALT). C. Reconstruction of the wide defect was performed using a chimeric ALT flap.

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  Fig. 5 A-C. Computed tomography, magnetic resonance imaging, and panoramic radiography revealed a large necrotic recurrent tumor in the right masticator space. D. The R-plate was exposed due to formation of an orocutaneous fistula in the right submandibular area.

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  Fig. 6 A, B. The chimeric flap was harvested for use in the reconstruction of both intraoral and extraoral areas. C, D. One skin paddle of the chimeric flap covered the intraoral defect, and the other covered the extraoral defect following removal of a recurrent tumor.

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  Fig. 7 A, B. Two months post-surgery, the intraoral and extraoral paddles of the chimeric flap remain intact and stable without any complications.

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  Fig. 8 A, B. The chimeric flap integrated well, and both the extraoral and intraoral areas healed well.

Reference

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