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Various vascularized flaps have been used for oral reconstruction after ablative cancer surgery. Among these, the radial forearm flap, rectus abdominis flap and anterolateral thigh perforator flap are the most popular options. In cases of tongue and mouth floor reconstruction, radial forearm fasciocutaneous flap has been the empirical choice for many years. However, it often carries cosmetic and functional problems on the donor site and limitations in flap size and volume. Considering these drawbacks, the anterolateral thigh perforator flap could be a good alternative. Generally, anterolateral thigh perforator flap has been used for tongue reconstruction due to the favorable flap thickness compared to the radial forearm flap. Furthermore, if a thin flap should be required solely for lining purpose, the flap thickness can be controlled through thinning procedures without circulatory compromise. For large composite tissue defects after cancer ablation surgery, the flap can be designed in a 3-dimensional plane and used for volumetric reconstruction as well as for adequate lining. Between September 2002 and September 2003, the authors used 15 anterolateral thigh perforator flaps for reconstruction of oropharyngeal defects after cancer ablation surgery in 15 patieints and analyzed the clinical data acquired retrospectively. Based on the results, we propose the indications and drawbacks of the anterolateral thigh flap in oropharyngeal reconstruction.
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