Abstract: PURPOSE: To investigate the feasibility and clinical effectiveness of using medial sural artery perforator flap for reconstruction of tongue defects, and to provide clinical applications of medial sural artery perforator flap in reconstruction of tongue defect. METHODS: Preoperative CT angiography (CTA) technique was performed in mapping the medial sural artery perforating branches in 9 Chinese adult patients with tongue squamous cell carcinoma. The perforator flap was used for tongue reconstruction in 9 patients. The function of reconstructed tongue and donor site were evaluated during 1 and 3 months postoperatively in 8 patients whose reconstructive tongue survived. RESULTS: The length of pedicle was long, the diameter of the vascular pedicle matched the recipient vessel in the neck region, with minor donor site complication. The reconstructed tongue was plump, the function of voice and swallowing was favorable, but the sensation was not good. As for the donor sites, all patients had only linear scars, there was no impact on their motor function. CONCLUSIONS: The medial sural artery perforator flap is thin and suitable for reconstruction of tongue defects. Postoperative voice and swallow are good. The donor site is unconspicuous without serious influence on shape and function. The medial sural artery perforator flap is an excellent alternative for tongue reconstruction.

Key words: Medial sural artery perforator flap, Tongue defect, Microsurgery