Application of a chimeric ALT perforator flap with vastus lateralis muscle mass in the reconstruction of the defects after radical resection of a buccal carcinoma: A retrospective clinical study.

BACKGROUND AND OBJECTIVES: Aggressive resection of buccal cancer simultaneously leaves both oral and lateral facial defects. It is unknown whether a perforator-based chimeric anterolateral thigh (ALT) flap, with a muscular component, is suitable for the reconstruction of these complicated defects. METHODS: In this retrospective study, 48 patients with a buccal carcinoma (T2 N0-1 M0), who underwent extensive surgical resection, were enrolled. Twenty-seven cases underwent reconstruction using the classical ALT perforator flap (classical group), and 21 cases used the chimeric ALT perforator flap with vastus lateralis muscle mass (chimeric group). The incidence of wound infection, lower limb extremity function, facial appearance, survival curves, and quality of life were compared between groups. RESULTS: The incidence of wound infection or effusion was lower in the chimeric group than in the classical group. The aesthetic result achieved in the chimeric group was better than in the classical group. Meanwhile, there was no significant difference in the function of the donor site between groups. CONCLUSIONS: The chimeric ALT perforator flap, with a muscular component, can reconstruct both the oral and lateral face defects accurately. It sustains the profile of the lateral face and decreases the incidence of wound infection.

Application of chimerical ALT perforator flap with vastus lateralis muscle mass for the reconstruction of oral and submandibular defects after radical resection of tongue carcinoma: a retrospective cohort study.

BACKGROUND: Patients with tongue carcinoma who undergo combined tongue and neck radical resection often have simultaneous oral and submandibular defects. Due to its high flexibility, the anterolateral thigh (ALT) perforator flap is gradually being adopted by surgeons for oral reconstruction. However, the tissue volume of perforator flaps is insufficient for the reconstruction of both the oral and submandibular regions. In this retrospective cohort study, we compared the postoperative outcomes and complications between patients reconstructed with using the classical ALT perforator flap and patients reconstructed using the chimeric ALT perforator flap with vastus lateralis muscle mass. METHODS: From August 2017 to August 2019, 25 patients underwent reconstructive therapy using a classical ALT perforator flap (classical group), while 26 patients were reconstructed with the chimeric ALT perforator flap (chimeric group) after radical resection of tongue cancer in Xiangya Hospital, Central South University. The flap survival rate, incidence of submandibular infection, lateral appearance, lower extremity function, and quality of life were compared between the two groups. RESULTS: There were no differences in flap survival rate and postoperative lower extremity function between the two groups. The incidence of submandibular infection was 15.4 and 40% in the chimeric and classical group, respectively. The duration of recovery was 12.20 ± 2.69 and 15.67 ± 4.09 days in the chimeric and classical group, respectively. The submandibular region fullness was satisfactory in the chimeric group. The postoperative quality of life in the chimeric group was better than that in the classical group (P < 0.05). CONCLUSIONS: The chimerical ALT perforator flap with muscle mass reconstructs both the oral and submandibular defects accurately. It maintains the profile and fullness of the submandibular region and may reduce the incidence of submandibular infection.