Abstract: Objective: To explore the application of microdissected thin anterolateral thigh flap in the repair of oral and maxillofacial soft tissue defects. Methods: From December 2015 to May 2018, 56 patients with oral and maxillofacial soft tissue defects were included. Preoperative CT angiography was conducted. Imaging workstations (Philips Medical Systems) were used to locate perforating vessels, design personalized flaps, simulate flaps cutting, and measure the fat thickness of the flaps. For 15 patients with thick subcutaneous fat, the adipose tissue was dissected after verifying the distribution of the blood vessels using an operating microscope. The whole flap was transposed to the recipient areas for microsurgical reparation. Results: 14 flaps survived completely. Only 1 flap suffered partial margin necrosis, which was healed after dressing change. The flap ranged from 9 cm×5 cm to 6 cm×4 cm in size. Donor recipient site was not severe complications, and secondary operative procedure was not needed in any patient in the follow-up. Conclusion: CT angiography can effectively guide the design of anterolateral thigh flap. For patients with thicker subcutaneous fat, microdissected thin anterolateral thigh flap was safe and reliable for patients with oral and maxillofacial soft tissue defects.

Key words: CT angiography, anterolateral thigh flap, soft tissue defect