Case Reports: PDF OnlyKoshima Isao MD; Yamamoto, Hidekazu MD; Moriguchi, Takahiko MD; Kawada, Shinsaku MD; Ono, Yohko MDAnnals of Plastic Surgery: October 1994 - p 421-425 Buy Abstract To reconstruct deep facial defects involving the facial nerves after resection of a malignant parotid tumor, a flap with a vascularized nerve graft is often required because the lesion is often accompanied by poor vascularization as a result of preoperative or postoperative radiotherapy. These defects can be repaired in one stage with a combined anteroposterior tibial perforator–based flap including a vascularized deep peroneal nerve graft. This combined flap can include the long vascularized deep peroneal nerve, and augumentation of the lower leg flaps is possible by additional vascular anastomosis of branches of the source vessel of the neighboring flap, the “mosaic” principle. © Williams & Wilkins 1994. All Rights Reserved.