Ibrahim M Ibrahim, Emily Clementi, Paul F Chisolm, Sagar Vasandani, Jonathan P Giurintano
{"title":"BMI, Sex as Predictors of Anterolateral Thigh Free Flap Thickness for Oropharyngeal Reconstructions.","authors":"Ibrahim M Ibrahim, Emily Clementi, Paul F Chisolm, Sagar Vasandani, Jonathan P Giurintano","doi":"10.1002/lary.70166","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the relationship between body mass index (BMI), sex, and anterolateral thigh free flap (ALTFF) thickness, and to determine their impact on the use of ALT and super-thin ALT (STALFF) flaps for oral and oropharyngeal reconstruction.</p><p><strong>Methods: </strong>Ninety-four patients who underwent ALTFF, super thin-ALTFF (ST-ALTFF), or radial forearm free flap (RFFF) reconstruction following resection of oral cavity and oropharyngeal squamous cell carcinoma were included. Preoperative PET/CT scans were analyzed to measure ALTFF thickness at three points along the thigh: the proximal fourth (Point A), midpoint (Point B), and distal fourth (Point C) of the line extending from the anterior superior iliac spine to the superior lateral surface of the patella. Statistical analyses included chi-squared, t-tests, ANOVA, and Pearson's correlation to assess associations between BMI, sex, and flap thickness.</p><p><strong>Results: </strong>Forty patients (42.5%) underwent ALTFF reconstruction, 18 had ST-ALTFF (19.1%), and 36 (38.3%) received RFFF. Pearson's correlation confirmed a strong positive relationship between BMI and flap thickness at all points (r > 0.62). Although BMI did not differ significantly between sexes (p = 0.066), females had significantly thicker flaps at all measured points (p < 0.0001).</p><p><strong>Conclusion: </strong>BMI and sex are reliable predictors of ALTFF thickness and influence flap selection. Integrating these factors into preoperative planning optimizes patient selection for free flap type choice, minimizing intraoperative modifications and improving reconstructive outcomes.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.70166","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To evaluate the relationship between body mass index (BMI), sex, and anterolateral thigh free flap (ALTFF) thickness, and to determine their impact on the use of ALT and super-thin ALT (STALFF) flaps for oral and oropharyngeal reconstruction.
Methods: Ninety-four patients who underwent ALTFF, super thin-ALTFF (ST-ALTFF), or radial forearm free flap (RFFF) reconstruction following resection of oral cavity and oropharyngeal squamous cell carcinoma were included. Preoperative PET/CT scans were analyzed to measure ALTFF thickness at three points along the thigh: the proximal fourth (Point A), midpoint (Point B), and distal fourth (Point C) of the line extending from the anterior superior iliac spine to the superior lateral surface of the patella. Statistical analyses included chi-squared, t-tests, ANOVA, and Pearson's correlation to assess associations between BMI, sex, and flap thickness.
Results: Forty patients (42.5%) underwent ALTFF reconstruction, 18 had ST-ALTFF (19.1%), and 36 (38.3%) received RFFF. Pearson's correlation confirmed a strong positive relationship between BMI and flap thickness at all points (r > 0.62). Although BMI did not differ significantly between sexes (p = 0.066), females had significantly thicker flaps at all measured points (p < 0.0001).
Conclusion: BMI and sex are reliable predictors of ALTFF thickness and influence flap selection. Integrating these factors into preoperative planning optimizes patient selection for free flap type choice, minimizing intraoperative modifications and improving reconstructive outcomes.
期刊介绍:
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects