Anterolateral thigh free flap for tracheal reconstruction after parastomal recurrence

Head Neck. 2009 Aug;31(8):1107-11. doi: 10.1002/hed.20992.


Background: Stomal recurrence after total laryngectomy is 1 of the most serious issues in head and neck surgery, both because of the complexity of its management and because of its morbidity. Prior to the introduction of free-tissue transfer, mediastinal tracheostomy has been the standard reconstructive procedure with high rate of complications. The ideal reconstructive solution to these problems must provide well-vascularized soft tissues that can cover the defect after resection and also allow suturing of the tracheal remnant to skin edges without tension.

Methods and results: We describe a case of a 56-year-old man with stomal recurrence after total laryngectomy treated by the use of a tubed anterolateral thigh (ALT) flap to elongate the shortened trachea and simultaneously cover the cervical skin defect.

Conclusions: The ALT can be accepted as an ideal free-flap choice for stomal recurrence, because it has maximal reconstructive capacity and produces minimal donor-site morbidity.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery*
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Positron-Emission Tomography
  • Reconstructive Surgical Procedures / methods*
  • Reoperation
  • Risk Assessment
  • Surgical Flaps*
  • Surgical Stomas / pathology
  • Thigh / surgery
  • Tracheal Neoplasms / diagnostic imaging
  • Tracheal Neoplasms / secondary*
  • Tracheal Neoplasms / surgery*
  • Treatment Outcome