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Background <p>Maxillectomy defects cause significant functional and aesthetic impairment. The anterolateral thigh (ALT) flap offers versatility for reconstruction. This note describes a flap modification to optimize outcomes in Class II defects.</p> Methods <p>An ALT flap was harvested with two skin paddles (oral and nasal) based on defect size. Partial T-shaped deepithelialization was done along the labial sulcus and nasal septum. The flap was inset in a folded “sandwich” configuration to reconstruct both palatal and nasal components. Naso-pharyngeal airways were placed postoperatively to maintain nasal patency. Tracheostomy ensured airway protection.</p> Results <p>The modified flap restored palatal continuity and nasal floor, maintained nasal patency, and supported midfacial contour. No nasal regurgitation or airway obstruction was observed. Speech and swallowing were satisfactory.</p> Conclusion <p>This ALT flap modification offers a reliable approach for maxillectomy defect reconstruction, ensuring functional recovery and improved healing with minimal complications.</p>

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Modification of ALT Flap for Reconstruction After Maxillectomy: A Technical Note

  • 期刊论文

  • 发表日期：

    2025年6月18日

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  • Saroj Kumari,
  • Anshuman Kumar,
  • Ehsan Z. Siddiqui,
  • Dimple Arora

摘要

Background

Maxillectomy defects cause significant functional and aesthetic impairment. The anterolateral thigh (ALT) flap offers versatility for reconstruction. This note describes a flap modification to optimize outcomes in Class II defects.

Methods

An ALT flap was harvested with two skin paddles (oral and nasal) based on defect size. Partial T-shaped deepithelialization was done along the labial sulcus and nasal septum. The flap was inset in a folded “sandwich” configuration to reconstruct both palatal and nasal components. Naso-pharyngeal airways were placed postoperatively to maintain nasal patency. Tracheostomy ensured airway protection.

Results

The modified flap restored palatal continuity and nasal floor, maintained nasal patency, and supported midfacial contour. No nasal regurgitation or airway obstruction was observed. Speech and swallowing were satisfactory.

Conclusion

This ALT flap modification offers a reliable approach for maxillectomy defect reconstruction, ensuring functional recovery and improved healing with minimal complications.