Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction

Different locoregional and free flaps were described for oral soft tissues reconstruction after oncological resections; however, free flaps remain the first choice. Among free flaps, the radial forearm flap (RFF) and the anterolateral thigh perforator flap (ALT) are preferred the most. The lack of s...

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Main Authors: Elisa Benanti, Marta Starnoni, Antonio Spaggiari, Massimo Pinelli, Giorgio De Santis
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2019-05-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1693504
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author Elisa Benanti
Marta Starnoni
Antonio Spaggiari
Massimo Pinelli
Giorgio De Santis
author_facet Elisa Benanti
Marta Starnoni
Antonio Spaggiari
Massimo Pinelli
Giorgio De Santis
author_sort Elisa Benanti
collection DOAJ
description Different locoregional and free flaps were described for oral soft tissues reconstruction after oncological resections; however, free flaps remain the first choice. Among free flaps, the radial forearm flap (RFF) and the anterolateral thigh perforator flap (ALT) are preferred the most. The lack of standardization of the flap choice leaves the selection to the surgeon's experience. The purpose of our observational study is to provide an algorithm to support the flap choice for the reconstruction of oral soft tissues. Sixty patients with squamous cell carcinoma of oral soft tissues were enrolled in our study. All the patients underwent preoperative magnetic resonance imaging (MRI) to measure the three-dimensional size of the tumor. During the follow-up, the patients were evaluated by using the University of Washington-Quality of Life Questionnaire. The questionnaire score was better for small tumors and worse for large tumors in both functional and relational fields. We observed that most of the overlapping results were obtained for small defects and the choice of RFF, as well as for large defects and the use of ALT. We observed that in the preoperative time, it is possible to select which flap between radial forearm and ALT is more appropriate for oral soft tissues defects reconstruction, according to the size of the tumor evaluated by MRI. We propose a decisional algorithm that suggests the type of flap to use between ALT and RFF.
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series Indian Journal of Plastic Surgery
spelling doaj-art-bc3fbe391568407eb7f314bb6de7654d2025-08-20T02:18:42ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2019-05-01520216617010.1055/s-0039-1693504Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues ReconstructionElisa Benanti0Marta Starnoni1Antonio Spaggiari2Massimo Pinelli3Giorgio De Santis4Department of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItaliaDepartment of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItaliaDepartment of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItaliaDepartment of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItaliaDepartment of Plastic and Reconstructive Surgery, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, ItaliaDifferent locoregional and free flaps were described for oral soft tissues reconstruction after oncological resections; however, free flaps remain the first choice. Among free flaps, the radial forearm flap (RFF) and the anterolateral thigh perforator flap (ALT) are preferred the most. The lack of standardization of the flap choice leaves the selection to the surgeon's experience. The purpose of our observational study is to provide an algorithm to support the flap choice for the reconstruction of oral soft tissues. Sixty patients with squamous cell carcinoma of oral soft tissues were enrolled in our study. All the patients underwent preoperative magnetic resonance imaging (MRI) to measure the three-dimensional size of the tumor. During the follow-up, the patients were evaluated by using the University of Washington-Quality of Life Questionnaire. The questionnaire score was better for small tumors and worse for large tumors in both functional and relational fields. We observed that most of the overlapping results were obtained for small defects and the choice of RFF, as well as for large defects and the use of ALT. We observed that in the preoperative time, it is possible to select which flap between radial forearm and ALT is more appropriate for oral soft tissues defects reconstruction, according to the size of the tumor evaluated by MRI. We propose a decisional algorithm that suggests the type of flap to use between ALT and RFF.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1693504oral soft tissue reconstructionradial forearm flapanterolateral thigh flapflap selection
spellingShingle Elisa Benanti
Marta Starnoni
Antonio Spaggiari
Massimo Pinelli
Giorgio De Santis
Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
Indian Journal of Plastic Surgery
oral soft tissue reconstruction
radial forearm flap
anterolateral thigh flap
flap selection
title Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
title_full Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
title_fullStr Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
title_full_unstemmed Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
title_short Objective Selection Criteria between ALT and Radial Forearm Flap in Oral Soft Tissues Reconstruction
title_sort objective selection criteria between alt and radial forearm flap in oral soft tissues reconstruction
topic oral soft tissue reconstruction
radial forearm flap
anterolateral thigh flap
flap selection
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1693504
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AT antoniospaggiari objectiveselectioncriteriabetweenaltandradialforearmflapinoralsofttissuesreconstruction
AT massimopinelli objectiveselectioncriteriabetweenaltandradialforearmflapinoralsofttissuesreconstruction
AT giorgiodesantis objectiveselectioncriteriabetweenaltandradialforearmflapinoralsofttissuesreconstruction