Microsurgical reconstruction of the tongue and the lower oral cavity was performed with a free ALT (Anterolateral thigh) free flap in the Military Medical Academy.

This demanding surgical method has been done for the first time in Serbia with a multidisciplinary approach, which is why the Military Medical Academy is recognizable. ALT flap is considered to be the golden standard for the treatment of this oncological defect in the world and represents the highest range of reconstructive surgery. Minimal damage to the donor region, good aesthetic and functional outcome, and rapid recovery of patients are the benefits of this method.

The operation was performed in a patient S.K, 51 years old, suffering from planocellular carcinoma of the lower oral cavity and tongue. Due to the large defects created after the removal of tumor changes, it was necessary to establish with the appropriate vascularized tissues from the other parts of the body the chewing, swallowing, breathing and speech functions. The extensive oncological surgery for the removal of tumor tissue was done by the surgical team of the Clinic for Maxillofacial Surgery of the MMA. Neck dissections from the right and left sides were done, the lymph nodes removed, as well as the resection of the central part of the lower jaw, which at the end of the operation was merged and fixed with titanium plates and screws, followed by an excised tumor change.

Since the standard methods were not adequate for the reconstruction of a defective defect in size two thirds of the tongue and two thirds of the lower oral cavity, it was decided that the microsurgical team of the Clinic for Plastic Surgery and Burns of the MMA use the ALT free flap. The so-called fasciocutaneous perforator flap size of the 14x7 cm was mounted on the blood vessels of 1.6mm diameter and then anastomosed to the blood vessels in the neck area (arterial and facial vein) by microsurgical technique.

A surgery lasting about 10 hours was carried out engaging a large number of medical MMA staff. From the Clinic for Maxillofacial Surgery Prof. Dr. Srboljub Stosic, Dr Sasa Jovic, Dr. Marko Brkic, Dr. Milena Borilovic participated, from the Clinic for Plastic Surgery, Major Dr. Nikola Ostojic, Dr. Ana Malivukovic, and from the Clinic for Anesthesiology and Intensive Therapy Dr. Uros Petrovic, as well as surgical nurses Dragana Vukovic, Marina Milosevic and Brankica Makragic.

The patient is well and successfully recovering.