Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence

✍ Scribed by Umberto Caliceti; Ottavio Piccin; Ottavio Cavicchi; Federico Contedini; Riccardo Cipriani

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 255 KB
• Volume: 31
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20992

✦ Synopsis

Abstract

Background

Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free‐tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well‐vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.

Methods and Results

We describe a case of a 56‐year‐old man with stomal recurrence after total laryngectomy treated by the use of a tubed anterolateral thigh (ALT) flap to elongate the shortened trachea and simultaneously cover the cervical skin defect.

Conclusions

The ALT can be accepted as an ideal free‐flap choice for stomal recurrence, because it has maximal reconstructive capacity and produces minimal donor‐site morbidity. © 2009 Wiley Periodicals, Inc. Head Neck, 2009