Assessing the suitability of medial sural artery perforator flaps in tongue reconstruction - An outcome study.
BACKGROUND
Oncological resection of the tongue can be reconstructed using a multitude of free flaps. The medial sural artery perforator (MSAP) flap has been well described in the literature in terms of its anatomy and harvest. However, functional outcome studies of post-reconstruction tongue defects using the MSAP flap have not been reported. This study represents the largest outcome study of patients with tongue reconstructions using MSAP flaps and a comprehensive review of its use.


METHODS
From December of 2010 to October of 2015, 579 patients with subtotal glossectomy and free flap reconstructions in Chang Gung Memorial Hospital were retrospectively reviewed. 27 patients were reconstructed with MSAP flap. The pre- and intra-operative factors, as well as flap-related factors were analyzed. Post-operative complications and functional outcomes were evaluated. Donor site assessment were also conducted.


RESULTS
A 96.3% flap survival rate was found with an average total operating time of 6 hours and 18 minutes. 84.6% of patients had primary closure of the donor site with and the remaining either had skin grafts or delayed closure. Donor site closure can be achieved primarily with no functional deficit. Speech intelligibility remained for most patients. 100% of patients resumed normal oral feeding.


CONCLUSIONS
The MSAP flap is a small to medium sized flap most suited for subtotal glossectomy defects where optimal outcomes can be achieved in terms of speech clarity and restoration of oral intake.
Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Taoyuan, Taiwan.
Shao-Yu
SY
Hung
Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Taoyuan, Taiwan.|Center for Vascularized Composite Allotransplantation, Chang Gung Memorial Hospital; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan.
Charles Yuen Yung
CY
Loh
Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Taoyuan, Taiwan.
Soo-Ha
SH
Kwon
Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chia-Hsuan
CH
Tsai
Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Kai-Ping
KP
Chang
Department of Plastic and Reconstructive Surgery; Chang Gung Memorial Hospital & Chang Gung University College of Medicine, Taoyuan, Taiwan.
Huang-Kai
HK
Kao
D000328:Adult; D001158:Arteries / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D005927:Glossectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D061525:Perforator Flap / Q000009:adverse effects*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D014059:Tongue / Q000098:blood supply / Q000601:surgery; D014062:Tongue Neoplasms / Q000601:surgery*