• Peter C Revenaugh, Timothy M Haffey, Rahul Seth, and Michael A Fritz.
• Head and Neck Institute, Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic, Cleveland, Ohio.
• JAMA Facial Plast Surg. 2014 Nov 1; 16 (6): 395-9.

ImportanceThis study describes a reliable technique for mucosal reconstruction of large defects using components of a common free flap technique.ObjectiveTo review the harvest technique and the varied scenarios in which the anterolateral thigh adipofascial flap (ALTAF) can be used for mucosal restoration in oral cavity and nasal reconstruction.Design, Setting, And ParticipantsA retrospective review of the medical records of 51 consecutive patients was conducted. The patients had undergone ALTAF head and neck reconstruction between January 2009 and June 2013. Each case was reviewed, and flap survival and goal-oriented results were evaluated.ResultsThirty patients met the inclusion criteria and were included in the analysis. The mean patient age was 60.6 years. Reconstruction sites included the tongue, palate, gingiva, floor of the mouth, and nasal mucosa. All mucosal reconstructions maintained function and form of replaced and preserved tissues. One patient (3%) experienced flap failure that was reconstructed with a contralateral adipofascial flap with excellent outcome. Three patients (10%) required minor flap revisions. There were no other complications.Conclusions And RelevanceThe ALTAF is a versatile flap easily harvested for use in several types of mucosal reconstructions.

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