Volumetric changes of the anterolateral thigh free flap following adjuvant radiotherapy in total parotidectomy reconstruction.

OBJECTIVES/HYPOTHESIS: The aim of this study was to prospectively evaluate volume change in anterolateral thigh free flaps pre- and postradiotherapy and to compare computed tomography (CT) volumetric analysis with intraoperative water displacement calculation.

STUDY

DESIGN

Matched pair cohort study.

METHODS

Thirteen patients with advanced carcinoma of the parotid gland underwent anterolateral thigh free flap reconstruction following total parotidectomy resections and neck dissection. Before the initiation of external beam radiation, routine CT planning scans were done on all patients. A minimum of 6 months after surgery, a CT scan of the head and neck was carried out, and a detailed volumetric assessment was performed.

RESULTS

The mean preradiotherapy flap volume was 94.3 mL, and the postradiotherapy volume was 84.8 mL. The mean volume reduction in all 13 patients was 8.12%.

CONCLUSIONS

In this prospective study we observed an 8% volume loss in anterolateral thigh free flaps 6 months postradiotherapy. This loss of volume should be taken into account when reconstructing large defects of the face and lateral skull base. Intraoperative water displacement measurement is a useful adjunctive tool for shaping free tissue transfers that are to be used for volume replacement and soft-tissue fill-in.