Soft Palate Reconstruction in Oral Cavity and Oropharyngeal Cancers

Joo, Young Hoon; Sun, Dong Il; Cho, Kwang Jae; Sung, Yong Hae; Cho, Seung Ho; Kim, Min Sik

Abstract

BACKGROUND AND OBJECTIVES: Various kinds of flaps are used for reconstruction of defected soft palate, and with these, physiologic functions can be preserved. We report the clinical results of our 44 consecutive soft palate reconstructions in oral and oropharyngeal cancers.
SUBJECTS AND METHOD
We reviewed the medical records of patients who were offered soft palate reconstruction with various kinds of flaps after ablative surgery of oral and oropharyngeal cancer from July 1997 to July 2004 and analyzed primary site, resection area of soft palate, reconstruction methods and postoperative functions using Modified barium swallow (MBS), articulation and resonance test.
RESULTS
Various kinds of flaps were used according to the resected area of soft palate. In cases of resection area less than 1/3 (63.6%), the reconstruction methods were local flap (7.1%), rectus abdominis myocutaneous flap (3.6%), lateral thigh free flap (LTFF)(3.6%), and radial forearm free flap (RFFF)(85.7%). In cases of resection area that is more than 1/3 of the total resection, all cases were reconstructed with RFFF, combining more complex techniques such as double folding, palmaris longus tendon, and superiorly-based pharyngeal flap. Velopharyngeal insufficiency (VPI) was examined in only 2 (11.8%) patients, and in residue after swallowing was examined in 10 (41.2%) patients. Postoperative pronunciation was 'good' in 15 (68.2%) patients.
CONCLUSION
In oral and oropharyngeal cancer, reconstruction of resected soft palate using various kinds of flaps is very useful and effective in postoperative physiologic functions such as in swallowing and pronunciation.