ABSTRACT
<p><b>OBJECTIVE</b>To summarize the application of 909 anterolateral thigh myocutaneous flaps in the repair of oral and maxillofacial defects and to examine their benefits in maxillofacial reconstruction of these defects.</p><p><b>METHODS</b>Patients were recruited from January 2004 to December 2012 in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital of Central South University. All patients underwent reconstructive surgery with anterolateral thigh myocutaneous flaps, and patient age ranged from 19 to 81 years with a mean of 51.2 years. There were 761 flaps showing single lobe and 148 flaps showing a multi-island pedicle. The largest area among the single flaps was 28 cm × 12 cm, and the smallest was 4 cm × 2 cm.</p><p><b>RESULTS</b>Among the 909 transferred flaps, 882 survived and 27 showed necrosis, with a survival rate of about 97.0%. The common complications at flap donor site were poor wound healing 9.6% (87/909), localized paresthesia 61.0% (500/820), and altered quadriceps force 15.0% (123/820). No case was presented with local serious complications, and 90% of the patients achieved good functional recovery and aesthetically acceptable results after the reconstruction by anterolateral thigh myocutaneous flaps.</p><p><b>CONCLUSIONS</b>The anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps and should be preferred.</p>