Korean J Otorhinolaryngol-Head Neck Surg.  2021 Mar;64(3):176-182. 10.3342/kjorl-hns.2019.00647.

The Usefulness of Medial Sural Artery Perforator Free Flap for Head and Neck Reconstruction

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 2Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background and Objectives
The ideal flap for head and neck reconstruction should be pliable, have sufficiently long pedicle and minimize donor defects. Anterolateral thigh free flap (ALTFF) and radial forearm free flap (RFFF) have been the workhorse flaps for head and neck reconstruction. However, ALTFF is too bulky and RFFF leaves a conspicuous scar on the donner site. Medial sural artery perforator free flap (MSAPFF) is a possible alternative, which has the benefit of thin RFFF and low donor site morbidity of ALTFF. Here, we evaluated for the first time the usefulness of MSAPF for head and neck reconstruction in Korean patients.
Subjects and Method
We carried out a retrospective study of patients who underwent MSAPFF for head and neck reconstruction from October 2018 to July 2019 by retrieving their data from electronic medical records. Patient characteristics, flap characteristics, surgical outcomes, and complications of donor sites were analyzed.
Results
Eight patients underwent MSAPFF reconstruction after head and neck surgery. The recipient sites were the following: the floor of the mouth, palate, tongue, the base of the tongue and nasolabial fold. The average median flap size was 34.1 cm2 (range 17.5-50 cm2), length 7.1 cm (5.0-10.0 cm), width 4.7 cm (range 3.5-5.0 cm), and pedicle length 9.2 cm (range 8-10 cm). There was one flap failure because of pedicle arterial insufficiency. All donor sites were closed primarily without any complication.
Conclusion
Based on the findings of this study, MSAPFF may be a new workhorse flap because it has thin, pliable tissue with low donor-site morbidity for head and neck reconstruction.

Keyword

Head and neck neoplasm; Head and neck reconstruction; Medial sural artery perforator flap; Microvascular free flap
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