Treatment of a mastoid defect by free anterolateral thigh flap

Abstract Introduction Free anterolateral thigh (ALT) flap constitutes an alternative to latissimus dorsi and radial forearm flaps for head and neck reconstruction. The authors report a case of mastoid reconstruction in a patient with multi-operated cholesteatoma associated with tubal dysfunction. Ca...

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Bibliographic Details
Published in:European annals of otorhinolaryngology, head and neck diseases head and neck diseases, 2016-06, Vol.133 (3), p.195-198
Main Authors: Pascal, S, Deveze, A, Casanova, D, Philandrianos, C
Format: Article
Language:English
Subjects:
Anterolateral
Cholesteatoma, Middle Ear - complications
Cholesteatoma, Middle Ear - surgery
Defect
Female
Fistula - etiology
Fistula - surgery
Flap
Free
Head and neck
Human health and pathology
Humans
Labyrinth
Life Sciences
Mastoid
Mastoid - surgery
Middle Aged
Otolaryngology
Reconstructive Surgical Procedures - methods
Semicircular Canals - surgery
Surgical Flaps
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Summary:Abstract Introduction Free anterolateral thigh (ALT) flap constitutes an alternative to latissimus dorsi and radial forearm flaps for head and neck reconstruction. The authors report a case of mastoid reconstruction in a patient with multi-operated cholesteatoma associated with tubal dysfunction. Case report This patient presented a fistula of the lateral semicircular canal and invagination of retroauricular soft tissues responsible for non-compensated almost complete areflexia with anacusis. She did not present any signs of cholesteatoma recurrence, but chronic inflammation of the mastoidectomy cavity. The head and neck procedure consisted of translabyrinthine labyrinthectomy: resection of the atrophic retroauricular skin, resection of the vestibular neurosensory tissue and obliteration of the mastoidectomy cavity. An ALT flap measuring 5 × 5 cm, anastomosed to the superior thyroid artery and facial vein, was used to cover the defect. Careful defatting of the flap allowed filling of the defect, while providing a sufficient quantity of appropriate tissue. The postoperative course was uneventful and the patient was considerably improved. The only donor site sequelae consisted of a thin linear scar. Conclusion The free anterolateral thigh flap, a reliable, polyvalent flap that can be shaped as needed and which is associated with minimal donor site morbidity, constitutes a good alternative for head and neck reconstruction.
ISSN:1879-7296
1879-730X
DOI:10.1016/j.anorl.2015.08.034