BACKGROUND: Microsurgical free flap is the method of choice for head and neck reconstruction. The aim of this study is to compare outcomes after head and neck reconstruction with ALT or RFF flaps and show versatility of ALT flap for soft tissue reconstruction. METHODS: Between 2017 and 2021 eighteen patients affected by head and neck cancer underwent a microvascular free flap reconstruction after tumor resection. RESULTS: Fourteen ALT and four RFF surgical procedures were performed. Flap survival was 100%. Systemic and local complications occurred in five cases of ALT group and in every patient of RFF group. CONCLUSIONS: The anterolateral thigh flap permits safe and easy reconstruction of head and neck defects. Primary closure could often be performed at the donor site and a variable pedicle permits different way of reconstruction. Individual patient factors and experience of the surgeon remain the determinants of the selection of the best reconstructive option.
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