Medial sural artery perforator flap for tongue and floor of mouth reconstruction

Abstract

The thin medial sural artery perforator flap permits high accuracy of tongue restoration and reduces the morbidity at the donor site.

Radical ablative surgery and radial forearm free flap (RFFF) reconstruction for patients with oral or oropharyngeal cancer: postoperative outcomes and oncologic and functional results

“…However, the skin paddle of the anterolateral thigh flap is often too thick, particularly in Caucasians, and dissection of its vascular pedicle is considered more difficult. The use of a medial sural artery perforator flap has been recently reported by Chen and colleagues for tongue and floor of the mouth reconstruction [20]. When the floor of the mouth including the mylohyoid complex is resected, a chimeric medial sural artery perforator flap, combining the fasciocutaneous flap and the medial gastrocnemius muscle flap supplied by different perforators, is particularly interesting in order to fill the dead space and decrease the risk of orocutaneous fistula.…”

Free profunda femoris artery perforator flap as a first-line choice of reconstruction for partial glossectomy defects

“…Debate about differences in functional outcomes of these 2 flaps is extensive, with most authors concluding that both have similar results and tending to favor the latter because of suggested better resistance to postradiotherapy deformity, donor site potential complications, and aesthetic concerns . Many other free flap options have been described for reconstruction of the partial glossectomy defect, including the lateral arm, gracilis, vertical rectus abdominis myocutaneous, tensor fasciae latae, peroneal artery, medial sural perforator, anteromedial, anterior tibial perforator, superficial circumflex iliac artery, deep inferior epigastric artery perforator, and supraclavicular and rectus abdominis musculoperitoneal flaps. Most of those flaps have shown good outcomes at the expense of a difficult dissection, donor site morbidity, inconvenience of flap harvest, or the need of more extensive (and expensive) preoperative evaluation, therefore, they are reserved as the second choice for comorbid patients or those in which traditional ALT or radial forearm could not be used for other reasons.…”

Pharyngoesophageal Reconstruction With the Medial Sural Artery Perforator Flap After Total Laryngopharyngectomy

“…The MSAP flap is an attractive choice compared with the "gold standard" anterolateral thigh flap because it is a thinner flap and can be used in head and neck reconstruction without thinning, 6 which can lead to the impairment of circulation or direct injury to the perforator, and the mean thickness this flap is more comparable to pharyngoesophageal wall thickness than is the anterolateral thigh flap. Other free flaps, such as the superficial circumflex iliac artery perforator (SCIP) flap, are also †Type I: a single branch; type IIA: dual branching pattern with high takeoff point above the tibial plateau; type IIB: dual branching pattern with low takeoff point below the tibial plateau; type III: 3 or more branches.…”

“…1 The anterolateral thigh flap has become the gold standard for pharyngoesophageal reconstruction [2][3][4] ; however, the free medial sural artery perforator (MSAP) flap, first described by Cavadas in 2001, 5 is an attractive alternative in head and neck reconstruction, particularly because the tissue is thinner. 6 We recently began using this flap to reconstruct circumferential pharyngoesophageal defects, a surgical approach which has not yet been reported in the literature. We have performed a total of 4 free MSAP flap transfers and report here these transfers and the management of the patients.…”