Clin Exp Otorhinolaryngol.  2008 Sep;1(3):161-165. 10.3342/ceo.2008.1.3.161.

Functional Benefit after Modification of Radial Forearm Free Flap for Soft Palate Reconstruction

• Kim JH
• Chu HR
• Kang JM
• Bae WJ
• Oh SJ
• Rho YS
• Ahn HY
• Jung CH

• KMID: 1486088
• DOI: http://doi.org/10.3342/ceo.2008.1.3.161

Abstract

OBJECTIVES
To compare the velopharyngeal function, swallowing and speech of the conventional and modified radial forearm free flap (RFFF) for soft palate reconstruction.
METHODS
Retrospective clinical study. Twenty-eight patients who underwent oropharyngeal reconstruction with RFFF were divided into two groups: 10 patients had conventional folded RFFF and 18 patients underwent modified method.
RESULTS
The average speech intelligibility score in modified RFFF group was 8.0+/-2.4, and 6.2+/-2.2 in conventional RFFF group (P<0.05). The nasalance was 27.4+/-7.8% in modified group and 38.6+/-2.7% in conventional group during no nasal passage reading and 43.6+/-7.3% in modified group, 55.2+/-7.6% in conventional group during high nasal passage reading (P<0.05). The subjective swallowing functional score was 2.8 in modified group and 2.1 in conventional group.
CONCLUSION
The speech assessment and nasalance demonstrate a more favorable outcome in modified group than conventional group.

Keyword

Radial forearm free flap; Reconstruction; Oropharyngeal cancer; Soft palate

MeSH Terms

Deglutition
Forearm
Free Tissue Flaps
Humans
Oropharyngeal Neoplasms
Palate, Soft
Retrospective Studies
Speech Intelligibility

Figure

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  Fig. 1 Design for conventional radial forearm free flap.

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  Fig. 2 Design for modified radial forearm free flap. Tri-lobed flap of which some portion was de-epithelialized (arrow) and sutured to the remaining soft palate.

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  Fig. 3 (A) Schematic design of modified radial forearm free flap. (B) De-epithelialized area of the flap sutures to the cut end of the soft palate.

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  Fig. 4 The appearance of the oropharynx after surgery in patients with conventional RFFF (A, B) and modified RFFF (C, D). (A) Conventional RFFF after 3 month. (B) Conventional RFFF after 12 month. (C) Modified RFFF after 3 month. (D) Modified RFFF after 12 month. RFFF: radial forearm free flap.

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