Radial Forearm Free Flap (RFFF) versus Anterolateral Thigh (ALT) Flap in Head and Neck Reconstruction

Abstract

This is a prospective comparative study that aimed to compare two techniques for reconstruction of head and neck defects resulting from different causes in different ages, the radial forearm free flap (RFFF) and the anterolateral thigh flap (ALTF).setting: The plastic surgery department of Sohag University Hospitals.Patients and methods: For this purpose, 18 patients with head and neck defects were recruited from the attendants of the plastic surgery department, Sohag University Hospital during the period from January 2019 to January 2021 with head and neck defects of different causes and were divided into 2 groups; group A included 10 patients for whom an RFFF was done for reconstruction and group B ( 8 patients), for whom the free ALT flap was done to reconstruct their defects. Results: The mean age for the whole group (mean+ SD) was 42.7 + 27 years.However, patients in group A were significantly older than those in group B ( 59.1 +18.5 versus 22.5 + 20.9 years respectively, p < 0.001). The commonest cause was excision of malignant tumors (10 cases) followed by traumatic defects (7 cases) and 1 case of Romberg’s disease. The overall success rate was 72.2% (11 fully survived flaps and 1 case of peripheral necrosis) while 5 cases were lost to follow up (27.8%). The overall complication rate was 55.6% (10 cases): 70% (7 cases) in group A 37.5% (3 cases) in group B. The follow up period ranged from 6 months to 1 year for both groups. Conclusion: The RFFF is preferred in the elderly and the ALT in the younger age group with care of venous drainage either by a large caliber vein or double vein drainag.