title: Pharyngoesophageal Reconstruction With the Medial Sural Artery Perforator Flap After Total Laryngopharyngectomy: A New Method.
abstract: BACKGROUND
  The medial sural artery perforator (MSAP) flap has become a popular target in head and neck reconstruction. This flap has many advantages compared with other free flaps but has not yet been used in the reconstruction of circumferential haryngoesophageal defects.
  
  
  METHODS
  Reconstruction of pharyngoesophageal circumferential defects using the MSAP flap was performed in 4 patients. The design of the flap was based on the perforators, which were confirmed by endoscopy. The MSAP flap was tubed and anastomosed end to end to the esophagus. The artery was anastomosed to the superior thyroid arteries, whereas the vein was anastomosed to the internal jugular vein.
  
  
  RESULTS
  All the flaps survived. All 4 patients gained acceptable speech and swallow function. One patient developed an infection at the donor site, a second developed fistulas, and a third experienced stricture. All complications were successfully treated.
  
  
  CONCLUSIONS
  Here, we demonstrated the use of the MSAP flap in reconstruction of circumferential pharyngoesophageal defects. Further application and follow-up studies should be performed.
authors.affiliation: From the *Department of Hand Surgery and Microsurgery Center, The First Affiliated Hospital, College of Medcine, ZheJiang University; and †The Children's Hospital, Zhejiang University School of Medicine, HangZhou, People's Republic of China.
authors.forename: Hui
authors.initials: H
authors.lastname: Shen
authors.forename: Xiang-Qian
authors.initials: XQ
authors.lastname: Shen
authors.forename: Ying
authors.initials: Y
authors.lastname: Lv
authors.forename: Jing-Hong
authors.initials: JH
authors.lastname: Xu
authors.forename: Hui
authors.initials: H
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply* / Q000637:transplantation; D006801:Humans; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000098:blood supply* / Q000637:transplantation; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures / Q000379:methods*