PMC7199551_01
An anterolateral thigh (ALT) flap was adopted to reconstruct the complicated scalp defects of a 62-year-old female patient. (a) The lesion was located at right lateral occipital region. (b) A radical excision of the lesion, skull bone, and relevant lymph nodes was performed with a titanium mesh implanted. (c) An ALT flap was harvested with part of quadriceps to fill the dead space. (d) The postoperative image of the patient. (e) The patient received radiotherapy and the flap maintained scalp contour at 12-month follow-up.
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A 62-year-old woman was diagnosed with adenocarcinoma with tumor invasion of the right mastoid and occiput (Figure 1(a)). An extensive excision of the tumor, underlying the skull bone and regional lymph node, was performed with titanium mesh implantation (Figure 1(b)). An ALT flap (13 x 15 cm) was used to cover the scalp defect (Figures 1(c) and 1(d)). The patient subsequently underwent radiotherapy, and within the 12-month follow-up period, no tumor relapse or flap abnormality were found (Figure 1(e)).
PMC7199551_02
An ALT flap was used to reconstruct the complicated scalp and calvarial defects of a female patient after decompressive craniectomy. (a) The patient presented with scalp necrosis and cerebrospinal fluid leak. (b) An ALT flap was used to reconstruct the defect. (c) The situation of the flap at 9-month follow-up without CSF leak.
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A 54-year-old woman in a persistent vegetative state had scalp necrosis at the incision of a previous decompressive surgery (Figure 3(a)). A thorough debridement of the lesion was performed before an ALT flap (7 x 12 cm) was used to reconstruct the defect (Figure 3(b)). The CSF lead was stopped postoperatively, and the condition of the flap was uneventful in the 9-month follow-up period (Figure 3(c)).