Anterolateral thigh flap harvested from paralyzed limbs in post-polio syndrome for tongue reconstruction-a case report and a review of the literature.

Abstract

Background: Poliomyelitis is an acute infectious disease caused by poliovirus in childhood. After the onset of acute poliomyelitis, weakness of limbs occurs 15 to 30 years later, which is defined as post-polio syndrome. Poliomyelitis accompanying head and neck cancer is rare. Microvascular reconstruction is a well-established procedure following extensive tumor resection. Donor-site selection for flap harvest is a very important issue in paralyzed patients, particularly in patients with post-polio syndrome. To date, limited information is available regarding flap harvest in paralyzed patients.

Case description: We present a case of a 70-year-old male who presented with oral squamous cell carcinoma of the tongue, with both lower extremities paralyzed due to childhood poliomyelitis. Reconstruction was successfully performed with an anterolateral thigh flap despite extensive muscle atrophy. The sizes of the vascular pedicle and the cutaneous perforators were anatomically similar to the ones of healthy limbs. Both donor and recipient sites healed uneventfully; however, a postoperative complication due to pneumonia occurred.

Conclusions: The present case demonstrates that flap harvest from paralyzed limbs in post-polio syndrome is safe, which is in line with the sparse evidence from the literature. However, our attention should be drawn to postoperative respiratory complications and management. In order to avoid postoperative complications, it is essential to undertake a precise preoperative assessment.