Efficacy of anterolateral thigh flap in oro-mandibular reconstruction: An original research

K. Jyothirmayee; Rohie Jawarker; Shivangini Kapoor; Jacob John Plackal; Dani Mihir Tusharbhai; Aananya Mishra

doi:10.53730/ijhs.v6nS3.7982

Authors

K. Jyothirmayee Assistant Professor, Department Of Oral and Maxillofacial Surgery, Government Dental College and Hospital, Afzalgunj, Hyderabad, Telangana
Rohie Jawarker
rohie90j@gmail.com
MDS, Oral and Maxillofacial Surgery, Consultant, Happy Smiles Dental Clinic, Bhopal, MP.
Shivangini Kapoor Consultant Oral and Maxillofacial Surgeon, Delhi
Jacob John Plackal MDS, Oral and Maxillofacial surgery, Fellow in Oral Oncosurgery (RGUHS), Sri Uthradom Thirunal Hospital, Trivandrum, Kerala
Dani Mihir Tusharbhai MDS, Oral and maxillofacial surgery, Research Fellow, Department of Head and Neck oncology, Tata memorial hospital, Parel, Mumbai
Aananya Mishra Final Year Postgraduate, Oral and maxillofacial surgery, Manipal college of Dental sciences,Mangalore, Manipal Academy of Higher Education, Manipal

Keywords:

oromandibular defect, functional head, neck reconstruction, anterolateral thigh flap, quality of life

Abstract

The purpose of this research was to evaluate the efficacy of utilizing the anterolateral flap from the thigh region for reconstructing the oro-mandibular defects when compared to other forms of flap reconstruction. A propensity score-matched analysis of patients with an oncologic head and neck defect who underwent microvascular reconstruction was performed. Two surgical groups, i.e., ALT (anterolateral thigh flap and bridging Plate) only and DFF (simultaneous soft tissue and vascularized bone flap), were created. Incidence and subsequent management strategies for postoperative plate exposure were evaluated along with complications, overall survival, and postoperative quality of life (QoL). Sixty-two patients were 1:1 propensity matched (31 per group). The DFF group had a significantly larger soft tissue and bone defect than the single-flap group. The 5-year probability of not having a plate exposure was 45.5 and 47.4% for the double-flaps and single-flap groups, respectively (p = 0.186). The ALT-only group had a significantly higher rate of wound infections (38.7% vs. 12.9%, p = 0.02). The incidence of flap loss, re-exploration, inpatient mortality, plate fracture, medical complications, and overall survival were not significantly different.

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