Comparison of Anterolateral Thigh and Radial Forearm Free Flaps in Head and Neck Reconstruction

Background: The radial forearm flap (RFF) and the anterolateral thigh flap (ALT) are commonly used for the reconstruction of head and neck soft-tissue defects. The aim of the study was to investigate and compare the surgical outcomes, complications and systemic condition of the patient after reconstruction of extensive head and neck defects with ALT or RFF following cancer extirpation. Patients and Methods: Between August 2011 and November 2013, a total of 36 patients affected by head and neck cancer (31 males and five females; mean age=64.7 years, range=40-86 years) underwent microsurgical reconstruction with 29 RFF and 10 ALT procedures. The surgical outcomes and complications among these two groups were retrospectively analyzed. Results: The success rate was 97% for the RFF group and 90% for the ALT group, with one total flap loss in each group. Donor-site complications occurred in 6% of the RFF group and in 7% of the ALT group. Seven RFF-treated patients (24%) and two treated with ALT (20%) experienced systemic complications. Statistical analysis confirmed no significant difference between the two groups regarding the variables investigated (p > 0.05). Conclusion: In our experience, ALT and RFF demonstrated analogous practicability and reliability for the reconstruction of head and neck soft-tissue defects, with similar local and systemic complications and donor-site morbidity rates.