Soft Palate Reconstruction with a Superior-Constrictor Advancement-Rotation Flap(SCARF)

Baek, Chung Hwan; Park, Kye Hoon; Kim, Byung Sik; Bang, Eun Guk; Chung, Yong Soo

Abstract

BACKGROUND AND OBJECTIVES: Reconstruction of the soft palate after tumor resection is a difficult surgical procedure because of the requirements of the dynamic functional velopharynx. The ideal technique should be simple, reliable, sensate, dynamic and fast, and should be performed transorally or transcervically. Many methods such as obturators, loco-regional flaps, and free flaps have been devised to reconstruct the soft palate but none meets all this criteria. Superior-constrictor advancement-rotation flap (SCARF) is a dynamic local myomucosal flap to achieve circumferential closure of the velopharynx and reestablish its valvular sphincteric function and this satisfies all the criteria mentioned above. We evaluated the validity of SCARF for reconstruction of the soft palate after tumor resection.
MATERIALS AND METHODS
From 1998 to 1999, three patients underwent a SCARF reconstruction of the velopharynx after 30% to 70% of the soft palate had been resected. All patients were evaluated after wound healing with regard to subjective satisfaction and objective parameters such as speech-language evaluation and videofluoroscopic study.
RESULTS
All patients reestablished velopharyngeal competence without significant phonatory or deglutitive disability. There was no donor site complication.
CONCLUSION
We could functionally reconstruct the defect of soft palate (maximum 70%) after tumor resection with SCARF. The SCARF reconstruction of the soft palate was simple, fast, reliable and performed transorally without any significant donor site morbidity.