Perforator Peroneal Artery Flap for Tongue Reconstruction

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Microsurgery

Background:

• Flap reconstruction has advanced significantly from primary closure to sophisticated techniques.
• Understanding flap vascularity has led to innovative reconstructive methods with minimal donor site morbidity.
• Peroneal artery perforator flaps are a valuable option for reconstruction.

Purpose of the Study:

• To evaluate the utility of the peroneal artery perforator flap for tongue reconstruction.
• To highlight the advantages of this flap, including thin, pliable tissue and minimal donor site morbidity.

Main Methods:

• A 57-year-old female patient underwent wide local excision and selective neck dissection.
• Perforators were identified using a handheld Doppler, and the flap was harvested under tourniquet.
• Anastomosis was performed to the ipsilateral facial vessels, with primary closure of the donor site.

Main Results:

• The peroneal artery perforator flap provided a thin, pliable flap for tongue reconstruction.
• The donor site had minimal morbidity and allowed for primary closure without a skin graft.
• The patient experienced uneventful healing after successful salvage of a post-operative arterial thrombus.

Conclusions:

• The peroneal artery perforator flap is a useful technique for reconstructing moderate tongue, buccal mucosa, and floor of mouth defects.
• Advantages include a thin, pliable flap, minimal donor site morbidity, and a hidden scar.
• This flap offers a valuable alternative to other reconstructive methods with potential donor site issues.