title: A prospective study of medial sural artery perforator flap with computed tomographic angiography-aided design in tongue reconstruction.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: 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.
authors.forename: Yue
authors.initials: Y
authors.lastname: He
authors.affiliation: 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.
authors.forename: Shu-Fang
authors.initials: SF
authors.lastname: Jin
authors.affiliation: 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.
authors.forename: Zhi-Yuan
authors.initials: ZY
authors.lastname: Zhang
authors.affiliation: Resident, Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Shao-Qing
authors.initials: SQ
authors.lastname: Feng
authors.affiliation: 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.
authors.forename: Chen-Ping
authors.initials: CP
authors.lastname: Zhang
authors.affiliation: Professor, Department of Plastic Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods*; D001158:Arteries / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014059:Tongue / Q000601:surgery*; D014062:Tongue Neoplasms / Q000601:surgery