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[Anterolateral thigh perforator flaps for facial reconstruction after tumour surgery].

BACKGROUND
Individual flap design and minor donor site morbidity are main criteria in the treatment of facial defects after tumour surgery. Microvascular perforator flaps seem to follow these criteria well. In the following study our experiences with microvascular anterolateral thigh perforator flaps (ALTPF) in reconstruction of the face following ablative tumour surgery are described and discussed in comparison to the present literature.


PATIENTS AND METHODS
In 19 patients with squamous cell carcinomas of the floor of the mouth (8), the cheek (6) or the mandible (5) of stadium T3 or T4 ablative tumour surgery followed by reconstruction was performed. For covering the soft tissue defects 19 ALTPF were used. In the five patients with carcinomas of the mandible a microvascular iliac crest transplant was combined with the anterolateral thigh perforator flap for complete chin reconstruction.


RESULTS
In one patient an intraoperative dissection of the perforator vessels happened. In all other patients surgery and postoperative period was free of complications. Five patients had minor second surgery for aesthetic of functional reasons. At the end there were good aesthetic and functional results in every patient.


CONCLUSIONS
The anterolateral thigh perforator flap is of great advantage in reconstruction of the face after tumour surgery. Individual designing, central and save perfusion, easy to be controlled, and a low incidence of donor site morbidity are their main advantages.