This is a prospective comparative study that aimed to
compare two techniques for reconstruction of head and neck
defects resulting from different causes in different ages, the
radial forearm free flap (RFFF) and the anterolateral thigh
flap (ALTF).
Setting: The Plastic Surgery Department of Sohag University
Hospitals.
Patients and Methods: For this purpose, 18 patients with
head and neck defects were recruited from the attendants of
The Plastic Surgery Department, Sohag University Hospital
during the period from January 2019 to January 2021 with
head and neck defects of different causes and were divided
into 2 groups; group A included 10 patients for whom anRFFF
was done for reconstruction and group B (8 patients), for
whom the free ALT flap was done to reconstruct their defects.
Results: The mean age for the whole group (mean ± SD)
was 42.7±27 years.
However, patients in group A were significantly older
than those in group B (59.1±18.5 versus 22.5±20.9 years
respectively, p < 0.001). The commonest cause was excision
of malignant tumors (10 cases) followed by traumatic defects
(7 cases) and 1 case of Romberg's disease. The overall success
rate was 72.2% (11 fully survived flaps and 1 case of peripheral
necrosis) while 5 cases were lost to follow-up (27.8%). The
overall complication rate was 55.6% (10 cases): 70% (7 cases)
in group A 37.5% (3 cases) in group B. The follow-up period
ranged from 6 months to 1 year for both groups.
Conclusion: The RFFF is preferred in the elderly and the
ALT in the younger age group with care of venous drainage
either by a large caliber vein or double vein drainage.
Key Words: Radial forearm free flap – Anterolateral thigh
flap – Head and neck.