Versatile anterolateral thigh perforator flap: case of tailored reconstruction for a large temporal and parotidectomy defect

Perforator flaps have introduced an advance in microsurgical reconstruction, by allowing the design of flaps that are tailored for a specific defect. In this report, the reconstructive technique in a case of temporal squamous-cell carcinoma is presented as an example of this trend. Following wide resection of the skin tumor, superficial parotidectomy was performed as a part of the lymph-node dissection. An anterolateral thigh perforator flap was harvested, including a segment of the vastus lateralis muscle in connection with the skin perforators, to reconstruct both the skin defect and the parotidectomy-related soft-tissue deficit. The muscle segment was reinnervated by the greater auricular nerve to diminish atrophy. The aesthetic result was satisfactory. Minor's starch-iodine test demonstrated prevention of Frey's syndrome. The anterolateral thigh flap is a versatile donor that allows individual variations in design for custom-made flaps.