Clinical application of various forms of free profunda femoral artery pedicled chimeric myocutaneous perforator flap in defect reconstruction after tongue carcinoma resection

Abstract

To investigate the clinical anatomy and application of free profunda femoral artery pedicled chimeric myocutaneous perforator flap in the defect reconstruction after radical resection of tongue carcinoma. Between April 2011 and January 2016, 44 cases of tongue carcinoma underwent radical resection, and tongue defects were reconstructed by free profunda femoral artery pedicled chimeric myocutaneous perforator flaps at the same stage. There were 40 males and 4 females, with a mean age of 46.3 years (range, 32-71 years). The pathologic type was squamous cell carcinoma, which involved the lingual margin in 24 cases, the ventral tongue in 17 cases, and the mouth floor in 3 cases. According to Union for International Cancer Control (UICC) TNM staging, 16 cases were rated as T 4N 0M 0, 11 cases as T 4N 1M 0, 9 cases as T 3N 1M 0, and 8 cases as T 3N 2M 0. The course of disease ranged from 1 to 22 months (mean, 8.6 months). The size of perforator flap ranged from 8.5 cm×4.0 cm to 12.0 cm×6.5 cm, and the size of muscle flap ranged from 4.0 cm×3.0 cm to 7.5 cm×5.0 cm. The adductor magnus myocutaneous flap with a pedicle of (8.3±0.5) cm was used in 11 cases, and the gracilis muscle myocutaneous flap with a pedicle of (8.1±0.8) cm was used in 33 cases. The donor sites were sutured directly. All 44 perforator flaps survived uneventfully, and the donor site healed well. The patients were followed up for 12 to 40 months (mean, 23.8 months). The reconstructed tongue had good appearance and function in swallowing and language. No local recurrence was found. Only linear scar was left at the donor sites. The free profunda femoral artery pedicled chimeric myocutaneous perforator flap can be harvested in various forms, and is an ideal choice to reconstruct defect after radical resection of tongue carcinoma.