Using a cross-cheek anterolateral thigh flap for simultaneous correction of trismus and oral cancer

Abstract

Oral cancers in association with trismus are commonly seen in clinical practice. Such a situation deserves special attention as it may complicate the tumour-ablative surgery and interfere with postoperative cancer surveillance. It follows that the simultaneous tackling of oral cancer and trismus should be pursued at any rate. In this presentation, a novel surgical approach using a cross-cheek anterolateral thigh (ALT) flap is introduced. With the special design in length, shape and orientation, this flap is capable of closing a wider defect area, sometimes extending across two functional regions (viz., posterior palate and trigonal area) without resort to two free flaps. As such, complex defects resulting from trismus release and tumour ablation can be readily repaired in a single stage. The advantages of such a technique include abundance in soft-tissue resources, proper flap quality and thickness, reliable blood supply, long and sizeable pedicle, ease in flap inset, need for only one recipient rather than two and the eradication of large area of mucosa that is predisposed to malignant transformation. The favourable outcome implicates that this innovative design could be a viable option in the management of such a clinical problem.