J Reconstr Microsurg 2017; 33(06): 389-394
DOI: 10.1055/s-0037-1599075
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Peroneal Flap for Tongue Reconstruction

Ying-Sheng Lin
1   Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Taiwan
,
Wen-Chung Liu
1   Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3   Department of Surgery, School of Medicine, National Defense Medical Center, Taipei, Taiwan
,
Yaoh-Shiang Lin
3   Department of Surgery, School of Medicine, National Defense Medical Center, Taipei, Taiwan
4   Department of Otolaryngology Head and Neck, Kaohsiung Veterans General Hospital, Taiwan
,
Lee-Wei Chen
1   Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
,
Kuo-Chung Yang
1   Division of Plastic and Reconstructive Surgery, Kaohsiung Veterans General Hospital, Taiwan
2   Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan
3   Department of Surgery, School of Medicine, National Defense Medical Center, Taipei, Taiwan
› Author Affiliations
Further Information

Publication History

06 October 2016

07 January 2017

Publication Date:
10 March 2017 (online)

Abstract

Background For large tongue defects, reconstructive surgeons have devised a variety of feasible options, such as radial forearm free flap and anterolateral thigh (ALT) flap. In our institution, peroneal flap has been the workhorse flap for the soft tissue defect in head and neck reconstruction. We present our experience using peroneal flap in tongue reconstruction.

Patients and Methods The study included 47 patients who had undergone tongue reconstructions with peroneal flaps after tumor resection. The size and location of the defect after tumor resection determined whether the peroneal flaps could be harvested as pure septocutaneous flaps to solely reconstruct the neotongue or to carry an additional muscle bulk to fill the adjacent defect. Retrospective chart review was used to look for postoperative complications and to perform functional assessments (which were also performed through telephone inquiry).

Results Of the 47 patients, 3 (6%) had flap failure and 1 (2.1%) had partial flap necrosis. The hemiglossectomy group had better results than the total glossectomy group with respect to speech and diet, but neither of these results reached statistical significance (p = 1.0 for speech and p = 0.06 for diet). The results of the subtotal glossectomy group were better than those of the total glossectomy group with respect to diet (p = 0.03). No statistically significant differences were noted among the three groups with respect to cosmetic aspect (p = 0.64).

Conclusions Considering its reasonable postoperative complication rates and functional results, peroneal flap can be considered a feasible option for tongue reconstruction.

Note

Presented at the Annual Meeting of the American Society of Plastic Surgery in Chicago, IL, October 2014.


 
  • References

  • 1 Manrique OJ, Leland HA, Langevin CJ. , et al. Optimizing outcomes following total and subtotal tongue reconstruction: a systematic review of the contemporary literature. J Reconstr Microsurg 2017; 33 (02) 103-111
  • 2 Engel H, Huang JJ, Lin CY. , et al. A strategic approach for tongue reconstruction to achieve predictable and improved functional and aesthetic outcomes. Plast Reconstr Surg 2010; 126 (06) 1967-1977
  • 3 Yang KC, Leung JK, Chen JS. Double-paddle peroneal tissue transfer for oromandibular reconstruction. Plast Reconstr Surg 2000; 106 (01) 47-55
  • 4 Daniel RK, Taylor GI. Distant transfer of an island flap by microvascular anastomoses. A clinical technique. Plast Reconstr Surg 1973; 52 (02) 111-117
  • 5 Hsiao HT, Leu YS, Lin CC. Tongue reconstruction with free radial forearm flap after hemiglossectomy: a functional assessment. J Reconstr Microsurg 2003; 19 (03) 137-142
  • 6 Yoshimura M, Imura S, Shimamura K, Yamauchi S, Nomura S. Peroneal flap for reconstruction in the extremity: preliminary report. Plast Reconstr Surg 1984; 74 (03) 402-409
  • 7 Lin YS, Liu WC, Chen LW, Yang KC. Peroneal flap in hypopharyngeal reconstruction. Ann Surg Oncol 2013; 20 (13) 4356-4361
  • 8 Liu WC, Yang KC. One-stage through-and-through cheek, lips, and oral commissure reconstruction using a double-paddle peroneal chimeric flap: an innovative method. Head Neck 2015; 37 (05) 662-669
  • 9 Maciejewski A, Szymczyk C, Wierzgoń J. Triple skin island fibula free flap: a good choice for combined mandible and tongue defect reconstruction. J Reconstr Microsurg 2008; 24 (07) 461-468
  • 10 Lin CT, Leung JK, Chen JS, Yang KC. Combined free fibular osteocutaneous-lateral calcaneal fasciocutaneous flap for reconstruction of composite oromandibular defects. Ann Plast Surg 2004; 53 (05) 442-448
  • 11 Potter JK, Lee MR, Oxford L, Wong C, Saint-Cyr M. Proximal peroneal perforator in dual-skin paddle configuration of fibula free flap for composite oral reconstruction. Plast Reconstr Surg 2014; 133 (06) 1485-1492
  • 12 Piazza C, Taglietti V, Nicolai P. Reconstructive options after total laryngectomy with subtotal or circumferential hypopharyngectomy and cervical esophagectomy. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (02) 77-88
  • 13 Liu WW, Li H, Guo ZM. , et al. Reconstruction of soft-tissue defects of the head and neck: radial forearm flap or anterolateral thigh flap?. Eur Arch Otorhinolaryngol 2011; 268 (12) 1809-1812
  • 14 Sassu P, Acland RD, Salgado CJ, Mardini S, Ozyurekoglu T. Anatomy and vascularization of the flexor hallucis longus muscle and its implication in free fibula flap transfer: an anatomical study. Ann Plast Surg 2010; 64 (02) 233-237
  • 15 Seo SW, Kim KN, Yoon CS. Extended scope of the use of the peroneal perforator flap in lower limb reconstruction. J Reconstr Microsurg 2015; 31 (09) 654-659
  • 16 Loewen IJ, Boliek CA, Harris J, Seikaly H, Rieger JM. Oral sensation and function: a comparison of patients with innervated radial forearm free flap reconstruction to healthy matched controls. Head Neck 2010; 32 (01) 85-95
  • 17 Leymarie N, Karsenti G, Sarfati B, Rimareix F, Kolb F. Modification of flap design for total mobile tongue reconstruction using a sensitive antero-lateral thigh flap. J Plast Reconstr Aesthet Surg 2012; 65 (07) e169-e174
  • 18 Longo B, Pagnoni M, Ferri G, Morello R, Santanelli F. The mushroom-shaped anterolateral thigh perforator flap for subtotal tongue reconstruction. Plast Reconstr Surg 2013; 132 (03) 656-665
  • 19 Selber JC. Discussion: reconstructive techniques in transoral robotic surgery for head and neck cancer: a North American survey. Plast Reconstr Surg 2013; 131 (02) 198e-199e
  • 20 Selber JC, Sarhane KA, Ibrahim AE, Holsinger FC. Transoral robotic reconstructive surgery. Semin Plast Surg 2014; 28 (01) 35-38