Selections and improvements in reconstruction of defects after head and neck tumor resection with anterolateral thigh free flap or modified pectoralis major myocutaneous flap

Abstract

Objective To explore the application and effect of anterolateral thigh free flap (ALTFF) and modified pectoralis major myocutaneous flap (PMMF) in the reconstruction of defects after radical resection of head and neck tumor. Methods From November 2011 to November 2016, 394 cases with head and neck tumor, including 286 males and 108 females, aged 25-79 years, underwent radical resection. The defect was reconstructed with anterolateral thigh free flap (306 cases) or modified pectoralis major myocutaneous flap (88 cases). The result and the quality of life of patients are investigated, the advantages and disadvantages of the two flaps are summarized. Results Survival rate of anterolateral thigh free flap and modified pectoralis major myocutaneous flap were 97.1% (297/306) and 97.7% (86/88) in 394 cases. The ALTFF group (3-4 h) and the PMMF group (1.5-2.5 h) have similar operative duration. Comparison of the UW-QOL scores of the ALTFF group and PMMF group 1 year post operation shows that the ALTFF group has significant advantages in appearance, speech and shoulder mobility, the difference was statistically significant (P<0.01). Conclusions Both of ALTFF group and PMMF group have high success rate in the reconstruction of defects after radical resection of head and neck tumor. Anterolateral thigh free flap is appropriate for the reconstruction of complex defects and modified pectoralis major myocutaneous flap is safer in patients with poor vascular conditions and systemic conditions. Key words: Anterolateral thigh free flap; Pectoralis major myocutaneous flap; Head and neck tumor; Oncoplastic surgery