Abstract
Anterolateral thigh flap (ALTF), since its first description, has challenged the role of the radial artery forearm free flap (RFFF) in head and neck reconstruction. The aim of our study was to objectively compare the two flaps in head and neck reconstruction. From March 2006 to January 2008, 61 head and neck reconstructions were done, 33 using RFFF and 28 using ALTF. Mean patient age was 46.93 years. There were 54 tumor and six trauma cases. Flap elevation time, pedicle length and diameter, flap failure, and re-exploration rates were not significantly different between the two flaps (p value=0.698, 0.978, 0.832, 0.908, respectively). Significantly larger flaps were harvested from the anterolateral thigh compared to the forearm (p value=0.000, 0.001). At the same time, the donor site complications were significantly lower in the ALTF cases (p value=0.029). Considering the larger amount of flap available from a hidden donor site with a reliable vascular pedicle and a low frequency of donor site morbidity, we recommend that ALTF should be considered as a first choice for soft tissue defects in the head and neck region.