Horizontal tongue flap in repair of tonsillar palatal defect

Local tissue, when available, seems superior to utilizing distant tissue for reconstruction of the tonsillar fossa region. Repair of the defect employing a horizontal posteriorly based tongue flap has been useful. It has the advantage of minimal decrease in the remaining tongue bulk and mobility, requires only 90 degrees rotation, and can be used after radiation therapy or ligation of the ipsilateral lingual artery.