Comparative Analysis of Super‐Thin Anterolateral Thigh and Radial Forearm Free Flap Reconstruction for Oral Cavity Defects

BACKGROUND: The radial forearm free flap (RFFF) has been a mainstay in head and neck reconstruction due to its reliability and pliability, but it carries notable donor-site morbidity. The super-thin anterolateral thigh free flap (ST-ALTFF) has recently emerged as a versatile alternative. METHODS: A retrospective chart review was performed including patients who underwent free flap reconstruction with either ST-ALTFF or RFFF following oral cavity squamous cell carcinoma resection. Demographic and peri-operative variables were collected, and statistical analysis was performed using the t-test, Mann-Whitney U test, and Fisher exact probability test. RESULTS: Twenty-one patients underwent ST-ALTFF and twenty-two underwent RFFF reconstruction. Patients receiving RFFF were more likely to be female (n = 16, p < 0.001) and have higher mean BMI (p = 0.048). Operative time was shorter with ST-ALTFF versus RFFF (509 vs. 594 min, p < 0.011). Other patient variables, complications, gastrostomy tube placement, and post-operative pain were similar. CONCLUSION: ST-ALTFF represents a viable reconstructive option with promising peri-operative outcomes compared to RFFF.