A prospective study of medial sural artery perforator flap with computed tomographic angiography-aided design in tongue reconstruction

Yue He; Shu-Fang Jin; Zhi-Yuan Zhang; Shao-Qing Feng; Chen-Ping Zhang; Yi-Xin Zhang

doi:10.1016/j.joms.2014.05.019

A prospective study of medial sural artery perforator flap with computed tomographic angiography-aided design in tongue reconstruction

J Oral Maxillofac Surg. 2014 Nov;72(11):2351-65. doi: 10.1016/j.joms.2014.05.019. Epub 2014 May 28.

Authors

Yue He¹, Shu-Fang Jin², Zhi-Yuan Zhang³, Shao-Qing Feng⁴, Chen-Ping Zhang¹, Yi-Xin Zhang⁵

Affiliations

¹ Professor, Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
² Resident, Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
³ Professor, Department of Oral Maxillofacial-Head Neck Oncology, Faculty of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China. Electronic address: zhzhy@sjtu.edu.cn.
⁴ Resident, Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
⁵ Professor, Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

PMID: 25149669
DOI: 10.1016/j.joms.2014.05.019

Abstract

Purpose: To investigate the application of the medial sural artery perforator flap in hemiglossectomy reconstruction and evaluate the value of preoperative computed tomographic angiography (CTA) for perforator location.

Patients and methods: Nine patients received medial sural artery perforator flaps for tongue reconstruction from August 2013 to January 2014. Of the 9 patients, 5 were male and 4 were female, with a mean age of 51 years (range 22 to 67). The number, location, and course of the perforators were measured on the CTA preoperatively.

Results: Of the 9 medial sural artery perforator flaps, 8 survived and 1 had developed necrosis. Thirteen perforators had been visualized by CTA, and 10 of these were used in the operation. No significant difference was found between the CTA location and the intraoperative findings in the perforators' distribution. The mean diameter of the medial sural artery was 1.0 ± 0.3 mm and of the concomitant vein was 2.0 ± 0.7 mm. The mean pedicle length was 9.7 ± 1.0 cm, with 5.1 ± 1.7 cm of the main trunk and 4.6 ± 2.1 cm of the perforator. The average number of muscular vessel branches was 23.9 ± 6.9, with 12.2 ± 5.1 from the main trunk and 10.1 ± 4.4 from the perforators; 1 (10%) perforator was septocutaneous and 9 (90%) were myocutaneous.

Conclusions: The medial sural artery perforator flap is appropriate for medium-size tongue defect reconstruction, with a long pedicle of matching caliber, adequate tissue volume, and minimal donor site morbidity. CTA is a valuable and necessary method for preoperative assessment of the perforator's location.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Angiography / methods*
Arteries / surgery*
Carcinoma, Squamous Cell / surgery
Female
Humans
Male
Middle Aged
Plastic Surgery Procedures / methods*
Prospective Studies
Surgical Flaps*
Tomography, X-Ray Computed / methods*
Tongue / surgery*
Tongue Neoplasms / surgery