Composite Anterolateral Thigh???Fascia Lata Flap: A Good Alternative to Radial Forearm???Palmaris Longus Flap for Total Lower Lip Reconstruction

Abstract

This flap is a good choice for reconstruction of the extensive head and neck defects. We think that anterolateral thigh-fascia lata composite flap has maximum reconstructive capacity and minimal donor-site morbidity. This flap has many advantages over the radial forearm flap and should replace to the composite radial forearm palmaris longus tendon flap when total lower lip reconstruction is concerned.

Functional reconstruction of complex lip and cheek defect with free composite anterolateral thigh flap and vascularized fascia

“…13 The vascularized fascia strip of ALT flap woven into the remaining lip muscle restores a complete ring of the oral sphincter. 21,23 Theoretically, with adequate tension, static suspension and dynamic function can be achieved in a single reconstruction with excellent symmetry of the reconstructed lip. However, 7 patients still underwent secondary procedures to improve dynamic oral incontinence.…”

“…[15][16][17]20,23 This technique offers many advantages such as large and pliable skin paddle, long vascular pedicle with a large diameter, and suitability for a simultaneous 2-team approach. Additionally, when compared with the radial forearm flap, the ALT flap sacrifices no major artery, and the donor-site defect can usually be closed primarily.…”

“…13 The disadvantage of all these methods is that they only allow a static suspension of the reconstructed lip to the oral commissure. 23 Many patients may still exhibit drooling, especially when speaking or eating. 8,11 Recent studies by this team introduced the palmaris longus tendon graft combined with the radial forearm-free flap as a good choice for 1-stage reconstruction of the oral sphincter in full-thickness cheek and oral commissure defects.…”

Reconstruction of the complete loss of upper and lower lips with a chimeric anterolateral thigh flap: A case report

“…Many patients still exhibit drooling, especially when speaking or eating. 12 In our case, a local flap could not be applied because of the lack of any residual lip tissue or oral mucosa; for such large defects, free tissue transfer is the first choice of reconstruction. There are few reports of reconstructing complete lip defects in the literature.…”

“…The reconstructive choice for lip defect was according to the defect size and area. Yildirim et al 12 reported that defects larger than 30% but smaller than 80% of the lower lip can be reconstructed with local flaps (e.g., advanced oral mucosal flaps, 5,6 extended lip flaps, 13,14 tongue flaps, or V-Y advancement flap 15 ). However, if the defect includes more than 80% of the lower lip, successful reconstruction is difficult because all of these methods allow only a static suspension of the reconstructed lip to the oral commissure.…”