Abstract
Objective The anterior-lateral thigh (ALT) free flap is a flexible reconstructive option with fascia lata, fasciocutaneous, and musculocutaneous options. The objective of this study is to evaluate ALT fascia lata free flap reconstruction of isolated hard palate defects.Methods Retrospective chart review of all palate reconstructions with ALT free flap from 2008-2017 by a single surgeon, at a tertiary academic institution. Patients with defects limited to the hard palate were selected for review.ResultsForty-eight patients were identified, of which 14 patients had limited palatal defects repaired with fascia lata free flaps and were selected for review. The average hospital stay for all patients was 2.8 days (range 1-4 days). Eighty-five percent of patients were started on an oral diet from post-operative day (POD) one. Ten of 14 were extubated at the end of the case, with four being extubated on POD one. One patient suffered donor site morbidity, which required intervention (one seroma requiring drainage). Two patients underwent minor palatal revisions with local tissue rearrangement for recurrent fistula. No patients suffered long-term velopharyngeal inadequacy (VPI) or dysphagia, and all reported normal nasal respiration.ConclusionThe ALT fascia lata free flap is a versatile reconstructive option for hard palate defects, with minimal morbidity, short hospital stays, and excellent long-term results.
Highlights
Reconstructive options for standard head and neck defects have advanced steadily, while the palatal and maxillectomy defect has continued to present a varied challenge to the reconstructive surgeon
Forty-eight patients were identified, of which 14 patients had limited palatal defects repaired with fascia lata free flaps and were selected for review
Eighty-five percent of patients were started on an oral diet from post-operative day (POD) one
Summary
Reconstructive options for standard head and neck defects have advanced steadily, while the palatal and maxillectomy defect has continued to present a varied challenge to the reconstructive surgeon. There remain a variety of distinct approaches for managing the maxillectomy defect, including obturator prosthesis placement, local tissue rearrangement, and a variety of free flap reconstructive options [1,2]. How to cite this article Kerr R P, Hanick A, Fritz M A (March 21, 2018) Fascia Lata Free Flap Reconstruction of Limited Hard Palate Defects. There exists a significant volume of literature discussing the various surgical reconstructive techniques for palatal defects. There has been little literature discussing the roles of free flap reconstructive techniques in limited palate or maxillectomy defects. Some reconstructive surgeons consider the morbidity, operative time, and hospital stay contraindications for free flap reconstruction for these smaller defects and recommend obturator rehabilitation
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