Background and objectives: Different free flaps have been used to reconstruct medium-sized defects after tongue cancer ablation. More recently, free medial sural artery perforator flap (MSAPF) has been used as an alternative. The authors investigated the outcome and donor-site morbidity of MSAPF used for tongue reconstruction.

Methods: Between October of 2009 and January of 2013, 17 patients (10 men and 7 women) underwent tongue reconstruction with MSAPF in the Oral and Maxillofacial Surgery Department at ‘12 de Octubre’ University Hospital (Madrid, Spain).

Results: Success rate of MSAPF was 94.11%. Defects were classified as mobile tongue ( n = 13) and base of tongue ( n = 4). Flap harvest mean time was 89 min. Average pedicle length was 12 cm (10–16 cm). Mean flap thickness was 0.9 cm (0.8–1.2 cm). Flap dimensions ranged from 5 to 14 cm in length and flap width was always less than 6 cm to allow direct closure. Overall donor site complication rate was 11.7% (2 patients presented suture dehiscence in lower limb).

Conclusions: MSAPF is an adequate alternative to reconstruct medium sized tongue defects in the Caucasian population. Pedicle anatomy and length are reliable.

Key words: perforator flap; medial sural artery; glossectomy; radial forearm flap