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전외측대퇴유리피판 (Anterolateral Thigh Free Flap)을 이용한 구강안면부 결손의 재건



Recently, the anterolateral thigh(ALT) flap, based on the septocutaneous vessels or musculocutaneous perforators from the descending branch of the lateral circumflex femoral artery has gained popularity in head and neck soft-tissue reconstruction. It has some advantages in free-flap surgery with respect to the radial forearm free flap, such as low donor site morbidity, availability of different tissues with large amounts of skin, adaptability as a sensate or flow-through flap (with the possibility of harvesting a long pedicle with a suitable vessel diameter). Moreover, the thickness of the flap is adjustable until the subdermal fat level, allowing it to be used as a thin or ultrathin flap. This clinical cases are ALT free flap reconstructions without functional impairment of the donor limbs (transitory and permanent) based on anastomosis with superficial temporal arteries and veins in patient of huge resection defect on face, lip and tongue.

참고문헌 (12)

  1. Kimura N, Satoh K: Consideration of a thin flap as an entity and clinical applications of the thin anterolateral thigh flap. Plast Reconstr Surg 97 : 985, 1996 
  2. Wolff KD : Indications of the vastus lateralis flap in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 36 : 358, 1998 
  3. Nayak JV, Teot LA, Vyas Y et al : Head and neck epithelioid sarcoma in a child: Diagnostic dilemma and anterolateral thigh free flap reconstruction. Inter J Ped Otorhinolaryngology 72(5) : 719, 2008 
  4. Song YG, Chen GZ, Song YL : The Free thigh flap: a new flap concept based on the septocutaneous artery. Br J Plast Surg 27 : 149, 1984 
  5. Sieh SJ, Chiu HY, Yu JC et al : Free anterolateral thigh flap for reconstruction of head and neck defects following cancer ablation. Plast Reconstr Surg 105 : 2349, 2000 
  6. Gedebou TM, Wei FC, Lin CH : Clinical experience of 1284 free anterolateral thigh flaps. Handchir Mikrochir Plast Chir 34 : 239, 2002 
  7. Chen CM, Chen CH, Lai CS et al : Anterolateral Thigh Flaps for Reconstruction of Head and Neck Defects. J Oral Maxillofac Surg 63(7) : 948, 2005 
  8. Ross GL, Dunn R, Kirkpatrick J : To thin or not to thin: the use of the anterolateral thigh flap in the reconstruction of intraoral defects. Br J Plast Surg 56 : 409, 2003 
  9. Wei FC, Jain V, Celik N et al : Have we found the ideal soft-tissue flap? An experience with 672 anterolateral thigh flaps. Plast Reconstr Surg 109 : 2219, 2002 
  10. Wolff KD, Kesting M, Thurmuller P et al : The anterolateral thigh as a universal donor site for soft tissue reconstruction in maxillofacial surgery. J Cranio-Maxillofac Surg 34 : 323, 2006 
  11. Agostini T, Agostini V : Further experience with adipofascial ALT flap for oral cavity reconstruction. J Plast Reconstr Aesth Surg 61(10) : 1164, 2008 
  12. Pinto F, Magalhaes R, Durazzo M et al : Galeal flap based on superficial temporal vessels for oral cavity and pharynx reconstruction-an anatomical study. Clinics 63(1) : 97, 2008 

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