Anterior Lateral Thigh Flap Salvage Reconstruction of Composite Defects after Recurrent Head and Neck Cancer

The anterior lateral thigh flap (ALTF) provides an excellent free tissue transfer option for one stage reconstruction of large soft tissue defects. The microvascular success rates are equivalent to other methods. Advantages of this flap are numerous. We describe a 64-year-old woman previously diagnosed with primary squamous cell carcinoma (SCC) of the head and neck. She underwent a local excision and primary closure with selective neck dissection followed by chemotherapy. A recurrence two years later was treated with a complete neck dissection and a second course of chemotherapy. Several years latter a second recurrence occurred. Composite surgical resection was performed, with concomitant reconstruction of the mandible and soft tissue with plate, screws and ALTF. The carotid artery and branch of the external jugular vein were used as the primary recipient vessels. Venous thrombosis occurred on post-operative day 1 and required repeat venous anastomosis. Ultimately, the flap survived completely with no partial flap necrosis.