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Table 1.

Statistical description of case series.

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Figure 1.

Preoperative view of two primary tumors.

Note that the left tongue cancer (T3N0M0) and left buccal cancer (T2N0M0) were not directly adjacent.

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Figure 2.

Preoperative view of left tongue cancer and right tongue mucosa leukoplakia.

The extensive mucosa leukoplakia (3×4 cm2) of right tongue was indicated to be resected.

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Figure 3.

Intraoperative view of three individual defects involved left half tongue, left buccal mucosa, and right tongue mucosa after the radical cancer ablation.

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Figure 4.

Intraoperative view after elevation of the tripaddled free ALT musculocutaneous flap.

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Figure 5.

Intraoperative view of three separately skin paddles covering left buccal, left tongue, as well as right tongue mucosa defect respectively.

Vascular anastomosis was made between the artery of the flap and the left superior thyroid artery and between the veins of the flap and the external jugular vein as well as a branch of internal jugular vein.

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Figure 6.

Appearance 2 months after operation with complete flap survival.

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Figure 7.

Preoperative view of a recurrent hypopharyngeal cancer invaded the anterior neck skin.

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Figure 8.

Intraoperative view of the resulting defects involved a part of esophagus and anterior neck skin after a radical salvage surgery including pharyngoesophagus, anterior neck skin and bilateral neck dissection.

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Figure 9.

Intraoperative view after harvest of bipaddled free ALT fasciocutaneous flap.

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Figure 10.

Intraoperative view of two separately skin paddles reconstructing neoesophagus and anterior neck skin respectively.

The distal paddle with two separately perforators was tubularized by itself to form a neoesophagus.

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Figure 11.

Appearance 14 days after operation with complete flap survival.

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Figure 12.

Preoperative view of trismus due to right buccal cancer and left OSF.

The preoperative month opening was severely limited.

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Figure 13.

Intraoperative view of right full-thickness cheek defects and left buccal mucosa defect after the radical cancer surgery.

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Figure 14.

Intraoperative view after harvest of a tripaddled free ALT musculocutaneous flap.

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Figure 15.

Early postoperative view of two proximal chimeric paddles restoring right full-thickness cheek defects and the distal paddle restoring left buccal defect.

The postoperative month opening was obviously improved.

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