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Motor and sensory morbidity associated with the anterolateral thigh perforator free flap
Author(s) -
Noel Christopher W.,
Vosler Peter S.,
Hong Michael,
Orsini Mario,
Sultanov Fayzullo,
Lu Zihang,
Busato GianMarco,
Enepekides Danny,
Higgins Kevin
Publication year - 2018
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.26865
Subject(s) - medicine , prospective cohort study , thigh , surgery , retrospective cohort study , isometric exercise , physical therapy
Objective To quantify changes in motor function, sensation, and lower extremity quality of life following anterior lateral thigh free flap (ALT) resection. Methods This mixed methods study contained both a prospective cohort arm (n = 20) and retrospective cross‐sectional arm (n = 20). In both arms, patients underwent formal motor and sensation testing of the ipsilateral and contralateral thigh by sphygmomanometry and monofilament testing. In the prospective arm, data was collected preoperatively and at the 6‐month and 1‐year follow‐up visits. In the retrospective arm, consecutive patients with a minimum of 6‐month postoperative follow‐up were enrolled. Results Postoperatively, 82% of participants endorsed some degree of numbness and tingling at the donor site. On monofilament testing, patients from the prospective arm showed decreased sensibility of the midthigh at both the 6‐ and 12‐month assessment ( P < 0.01). Two‐point discrimination scores were moderately correlated with the cross‐sectional surface area of the flap. Donor thighs demonstrated a similar peak isometric quadriceps contraction (retrospective [retro]: 47 ± 24 mmHg, prospective [pro]: 90 ± 36 mmHg) to the unoperated thighs (retro: 43 mmHg ± 22, pro: 69 ± 35.3 mmHg, P = 0.49). When stratified by perforator anatomy, no significant differences were noted. Subjective donor site morbidity measured with the lower extremity function scale demonstrated no statistically significant difference between the preoperative and 12‐month postoperative assessment. Conclusion The ALT flap offers minimal donor site morbidity. Reduced sensibility of the ALT flap is a common complaint among patients. Quadriceps strength is not significantly affected by an ALT free flap harvest. Level of Evidence 4. Laryngoscope , 128:1057–1061, 2018