N D Futran1, J R Haller. 1. Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, Seattle 98195-6515, USA. futran@otomail.u.washington.edu
Abstract
OBJECTIVE: To evaluate the use of microvascular free-tissue transfers in the reconstruction of hard palate defects. DESIGN: Retrospective review of a case series. SETTING: Two tertiary referral centers. PATIENTS: Thirty patients had hard palatal defects that resulted from ablative oncologic surgery: 10 total or subtotal palatal defects, 14 hemipalatal defects, and 6 anterior arch defects. INTERVENTION: Nine fibular, 11 rectus abdominus, 3 scapular, 6 radial forearm, and 1 latissimus dorsi free flaps were used to reconstruct these defects. MAIN OUTCOME MEASURES: Separation of the oral cavity from the nasal and sinus cavities, complications, oral diet, speech intelligibility, and overall quality of life. RESULTS: No flap failures occurred, and all palatal defects were ultimately sealed. Nineteen patients eat a regular diet, while the remainder maintain a soft diet. Twelve patients use a conventional dental prosthesis; 8 of the dental prostheses are supported by implants. Of 23 patients examined for speech, 18 have no disorders, 3 exhibit hyponasal speech, and 2 have hypernasal speech. Overall University of Washington, Seattle, quality of life scores were fair in 2 patients, good in 6, and excellent in 12. CONCLUSIONS: Free-flap reconstruction of the palate provides reliable permanent separation of the oral and sinonasal cavities in one stage. In addition, the potential for dental rehabilitation with the restoration of masticatory function and normal phonation exists. Flap choice is tailored to specific palatal defects as well as patient needs.
OBJECTIVE: To evaluate the use of microvascular free-tissue transfers in the reconstruction of hard palate defects. DESIGN: Retrospective review of a case series. SETTING: Two tertiary referral centers. PATIENTS: Thirty patients had hard palatal defects that resulted from ablative oncologic surgery: 10 total or subtotal palatal defects, 14 hemipalatal defects, and 6 anterior arch defects. INTERVENTION: Nine fibular, 11 rectus abdominus, 3 scapular, 6 radial forearm, and 1 latissimus dorsi free flaps were used to reconstruct these defects. MAIN OUTCOME MEASURES: Separation of the oral cavity from the nasal and sinus cavities, complications, oral diet, speech intelligibility, and overall quality of life. RESULTS: No flap failures occurred, and all palatal defects were ultimately sealed. Nineteen patients eat a regular diet, while the remainder maintain a soft diet. Twelve patients use a conventional dental prosthesis; 8 of the dental prostheses are supported by implants. Of 23 patients examined for speech, 18 have no disorders, 3 exhibit hyponasal speech, and 2 have hypernasal speech. Overall University of Washington, Seattle, quality of life scores were fair in 2 patients, good in 6, and excellent in 12. CONCLUSIONS: Free-flap reconstruction of the palate provides reliable permanent separation of the oral and sinonasal cavities in one stage. In addition, the potential for dental rehabilitation with the restoration of masticatory function and normal phonation exists. Flap choice is tailored to specific palatal defects as well as patient needs.
Authors: Brittany N Allen; Qi Wang; Yassine Filali; Kristan S Worthington; Deborah S F Kacmarynski Journal: Tissue Eng Part B Rev Date: 2022-01-24 Impact factor: 7.376
Authors: Remco de Bree; Alessandra Rinaldo; Eric M Genden; Carlos Suárez; Juan Pablo Rodrigo; Johannes J Fagan; Luiz P Kowalski; Alfio Ferlito; C René Leemans Journal: Eur Arch Otorhinolaryngol Date: 2007-08-08 Impact factor: 2.503