title: Functional outcome in soft palate reconstruction using a radial forearm free flap in conjunction with a superiorly based pharyngeal flap.
abstract: BACKGROUND
  Speech and swallowing problems due to velopharyngeal incompetence may follow soft palate resection and reconstruction. Over the past 3 years, we have developed the use of a superiorly based pharyngeal flap in conjunction with a radial forearm flap for soft palate reconstruction.
  
  
  METHODS
  This paper describes the technique in detail and compares the functional results in a study with patients undergoing soft palate resection for squamous cell carcinoma treated with or without a pharyngeal flap as an adjunct to a radial forearm free flap for soft palate reconstruction. Seven patients had one quarter or one half soft palate defects reconstructed with a radial forearm flap alone. Of the 11 patients undergoing three quarter or total soft palate resections, all were reconstructed with a radial forearm flap, but 5 were treated with an additional superiorly based pharyngeal flap. The functional outcome for all the patients was analyzed and compared.
  
  
  RESULTS
  Our results show that the addition of the superiorly based pharyngeal to the radical forearm flap in soft palate reconstruction results in improved speech and swallowing. We recommend the use of the additional flap in resections in which more than one quarter of the soft palate is included.
authors.affiliation: Regional Maxillofacial Unit, Walton Hospital, Liverpool, Merseyside, United Kingdom.
authors.forename: J S
authors.initials: JS
authors.lastname: Brown
authors.forename: A C
authors.initials: AC
authors.lastname: Zuydam
authors.forename: D C
authors.initials: DC
authors.lastname: Jones
authors.forename: S N
authors.initials: SN
authors.lastname: Rogers
authors.forename: E D
authors.initials: ED
authors.lastname: Vaughan
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D002933:Cineradiography; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D010157:Palatal Neoplasms / Q000534:rehabilitation / Q000601:surgery; D010160:Palate, Soft / Q000502:physiology / Q000601:surgery*; D010609:Pharyngeal Muscles / Q000637:transplantation*; D010614:Pharynx / Q000502:physiology; D011884:Radius; D012189:Retrospective Studies; D013060:Speech / Q000502:physiology; D013064:Speech Disorders / Q000209:etiology; D013065:Speech Intelligibility; D013524:Surgical Flaps / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000209:etiology