{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:17:47Z","timestamp":1782793067933,"version":"3.54.5"},"reference-count":12,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To demonstrate that the anterolateral thigh fascia lata (ALTFL) rescue flap may be effectively used for management of osteoradionecrosis (ORN) in selected patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective chart review was performed on patients who underwent ALTFL free flap repair to various sites of ORN in the head and neck between 2011 and 2018. Inclusion criteria were patients with radiographic and clinical evidence of head and neck ORN who either failed previous hyperbaric oxygen (HBO) therapy or with extensive disease, which was unlikely to respond to conservative management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010three patients with average age of 63\u2009years (40\u201378) who underwent 24 ALTFL free flap procedures were reviewed. ORN sites were the mandible (n\u00a0=\u00a016), palatomaxilla (n\u00a0=\u00a04), skull base and cervical spine (n\u00a0=\u00a03), and calvarium (n\u00a0=\u00a02). Recipient vessels used were superficial temporal (n\u00a0=\u00a011), common facial (n\u00a0=\u00a010), and angular (n\u00a0=\u00a03). Average hospital stay was 3.0 (1\u201310) days. Prior HBO therapy was performed in 13 (57%) patients. There were four major complications: flap failure, recurrent mandibular infection resolved with IV antibiotic course, mandibular fracture with malunion requiring occlusal adjustment, and unresolved sequelae of ORN requiring fibular free flap. There were four minor complications: thigh hematoma, thigh seroma, and intraoral scar formation causing trismus (n\u00a0=\u00a02). The procedure was successful in 22 of 23 (95.7%) patients with radiographic arrest of ORN, resolution of symptoms, and elimination of antibiotic requirements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The ALTFL rescue flap merits strong consideration in ORN management and appears to prevent progression to more extensive disease, which would require full segmental bone resection and reconstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2688\u20132693, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29709","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T15:53:31Z","timestamp":1628265211000},"page":"2688-2693","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Anterolateral Thigh Fascia Lata Rescue Flap: A New Weapon in the Battle Against <scp>Osteoradionecrosis<\/scp>"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5847-8977","authenticated-orcid":false,"given":"Joseph B.","family":"Meleca","sequence":"first","affiliation":[{"name":"Facial Plastic and Microvascular Surgery Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhorie P.","family":"Kerr","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery University of California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. L.","family":"Prendes","sequence":"additional","affiliation":[{"name":"Facial Plastic and Microvascular Surgery Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Fritz","sequence":"additional","affiliation":[{"name":"Facial Plastic and Microvascular Surgery Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.moo.0000170527.59017.ff"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(83)80005-6"},{"key":"e_1_2_6_4_1","first-page":"140","article-title":"The pathogenesis of osteoradionecrosis","volume":"94","author":"Dambrain R","year":"1993","journal-title":"Rev Stomatol Chir Maxillofac"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2003.11.009"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2004.05.204"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2004.08.021"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2004.04.005"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.09.006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2019.07.006"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.249"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26047"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199908000-00005"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29709","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29709","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T16:12:35Z","timestamp":1693239155000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":12,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1002\/lary.29709"],"URL":"https:\/\/doi.org\/10.1002\/lary.29709","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2020-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}