title: A new mucosal propeller flap (deep lingual artery axial propeller): the renaissance of lingual flaps.
abstract: BACKGROUND
  Lingual flaps provide ideal mucosal coverage for intraoral defects but traditionally require two surgical stages. The authors present an axial mucosal propeller flap for single-stage intraoral reconstruction. The flap includes the mucosa of the lateral side of the tongue, islanded on the deep lingual vessels.
  
  
  METHODS
  Between 2011 and 2013, 23 patients underwent intraoral mucosal reconstruction with a deep lingual artery axial propeller flap after cancer resection in the cheek (n = 16), floor of the mouth (n = 2), retromolar trigone (n = 2), hard palate (n = 2), and soft palate (n = 1). Mean defect size was 19.5 cm. Preoperative and postoperative intraoral function was evaluated with the Functional Intraoral Glasgow Scale.
  
  
  RESULTS
  The authors always achieved one-stage reconstruction with primary donor-site closure. The only complications were an infection treated conservatively and a late oronasal fistula caused by radiotherapy. All patients resumed an oral diet after 1 week and none required surgical revision. Mean 12-month postoperative Functional Intraoral Glasgow Scale score was better than the preoperative score (13.5 versus 12.8).
  
  
  CONCLUSIONS
  The deep lingual artery axial propeller flap combines the advantages of the traditional lingual flap (i.e., reliable axial vascularization and like-with-like reconstruction) with those of a propeller flap (i.e., one-stage transfer of like tissue and extreme mobility) and has wider indications than a conventional lingual flap. The technique is fast and has low morbidity and good functional results, and the authors recommend it as a first-choice technique to reconstruct moderate to large intraoral defects.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Palermo, Italy From Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo.
authors.forename: Adriana
authors.initials: A
authors.lastname: Cordova
authors.forename: Francesca
authors.initials: F
authors.lastname: Toia
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Arpa
authors.forename: Gabriele
authors.initials: G
authors.lastname: Giunta
authors.forename: Francesco
authors.initials: F
authors.lastname: Moschella
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery*; D009062:Mouth Neoplasms / Q000601:surgery*; D019647:Oral Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*; D014059:Tongue / Q000637:transplantation*; D016896:Treatment Outcome