OBJECTIVETo study the anatomic features of the gracilis muscle flap and its clinical application in tongue reconstruction.

METHODSThirty gracilis muscles in 15 cadavers were dissected, and the morphometric parameter of the gracilis muscle and the origin, length, diameter of the vascular and nerve pedicle were observed and measured.

RESULTSThe length of the total gracilis and the muscle belly was 41.8±3.9 cm and 31.0±3.6 cm respectively, and the width and thickness of the muscle was 3.2±0.7 cm and 1.7±0.2 cm respectively. The blood supply to the gracilis originated from multiple source vessles, and two to five pedicles supplied the gracilis from its deep surface and entered the muscle near its anterior border, of which the dominant pedicle and the first distal pedicle were consistent in their anatomy which originated from the profunda femoris vessels and the femoris vessels respectively. The length and external diameter of these vessels were suitable for microvascular anastomosis, while other vessel pedicles were neither consistent in their anatomy nor the length and external diamiter suitable for microvascular anastomosis. The nerve to the gracilis arose from the anterior division of the obturator nerve consistently and its length and external diameter was suitable for anastomosis with the hypoglossal nerve.

CONCLUSIONSBecause of superficial location, excellent morphological match for tongue, consistency in its vascular and neural pedicle's anatomy and suitability of neurovascular pedicle's length and external diameter for microsurgical anastomoses, possibility of regaining tongue movements, the gracilis flap is a ideal option for tongue reconstruction.