Tongue reconstruction with minimal donor site morbidity using a deep inferior epigastric perforator (DIEP) free flap in a 6‐year‐old girl

Abstract

Tongue reconstruction was performed using a deep inferior epigastric perforator (DIEP) free flap in a 6-year-old girl with undifferentiated sarcoma of the tongue. After hemi-glossectomy with upper neck dissection, a 3-lobed DIEP free flap was used for the reconstruction. Donor site was closed primarily with suturing umbilicus in proper position. No flap loss, leakage, or infection occurred. Postoperatively, the patient was able to consume a normal diet without difficulty or aspiration and displayed good speech function. No donor site morbidity, e.g., herniation or bulging, was observed, and the patient was able to perform their normal daily activities. DIEP flaps provide a pliable skin paddle, an adequate amount of adipose tissue, and reduced donor site morbidity, even in children. We did not have any difficulty harvesting the DIEP flap or with the microvascular anastomosis. We consider DIEP free flaps to be the ideal option for pediatric tongue reconstruction.

The deep inferior epigastric artery perforator flap: a narrative review on its various uses in non-breast reconstruction

“…The abdominoplasty-like transverse design is also proposed in some of the articles ( 18 , 76 , 77 ) although some variations exist. Yano et al ( 65 ) described a DIEP flap that has three lobes and a single perforator. Adding a shallow incision on the surface between the second and third lobe helps in creating a crease for three-dimensional spatial flap in-setting.…”

“…It is also worth noting that non-breast reconstruction using the DIEP flap is not a common technique employed by most reconstructive surgeons. Those who publish the different reports are usually from the same working groups [Yano et al ( 65 , 66 ), Zhang et al ( 67 , 75 , 104 ) or Kostakoğlu et al ( 18 , 76 )].…”

A Simple Skin Incision Design for Pediatric Superficial Branch of Superficial Circumflex Iliac Artery

“…The SCIP flap vascularized based on the superficial branch (SB-SCIP flap) has the following advantages: decreased donor morbidity, 9–11 reliable vascularity, 4,12 short time for flap elevation, 1,8,13 and multiple tissue/component inclusion. 13–17…”

Long‐term functional outcomes after total tongue reconstruction: Consideration of flap types, volume, and functional results

“…Engel et al recently reported that the reconstructive goal for patients with one‐third residual tongue tissue is to maintain mobility using a thin and pliable flap. In these patients, a radial forearm free flap is widely recommended, although in thin patients, a thin perforator flap can sometimes be used instead . By contrast, patients with a total glossectomy require restoration of volume using a bulky musculocutaneous flap to prevent aspiration and achieve proper deglutition.…”