title: Hard palate resection, microvascular reconstruction, and prosthetic restoration: a 14-year retrospective analysis.
abstract: BACKGROUND
  This retrospective analysis was conducted to evaluate self-reported patient and clinician assessed functional outcomes of patients who have undergone ablative hard palate oncologic resection and microvascular free-flap reconstruction with and without maxillofacial prosthetic intervention.
  
  
  METHODS
  All Head and Neck Surgery Service, Plastic and Reconstruction Surgery Service, and Dental Service charts and progress notes entered into the Institutional Health Care Information System of 57 patients who underwent hard palate resection and microvascular reconstruction at Memorial Sloan-Kettering Cancer Center (MSKCC) between January 1, 1988, and December 31, 2001 were reviewed retrospectively by three maxillofacial prosthodontists (BJB, JMH, IMZ). Prosthetic and nonprosthetic rehabilitation outcomes for each patient were reported as having normal; limited; or poor esthetics and function according to each prosthodontist's clinical evaluations; patients' self-perceptions; and feedback from friends, family members, and/or spouse. Speech intelligibility was determined in the same manner but reported as normal, hypernasal, and hyponasal.
  
  
  RESULTS
  Most of the 26 prosthetically rehabilitated patients were reported as having normal esthetics (81%), normal function (77%), normal speech (96%), and were able to return to per oral full diets (81%) without any restrictions.
  
  
  CONCLUSIONS
  Acceptable oral rehabilitation outcomes were reported for most prosthetically rehabilitated free-flap patients. Normal speech can be anticipated with a high degree of certainty, and a high percentage of prosthetically restored free-flap patients achieved per oral diets.
authors.affiliation: Dental Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Bernhart
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Huryn
authors.forename: Joseph
authors.initials: J
authors.lastname: Disa
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Ian M
authors.initials: IM
authors.lastname: Zlotolow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000534:rehabilitation / Q000601:surgery; D002648:Child; D004032:Diet; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D008875:Middle Aged; D021362:Palate, Hard / Q000098:blood supply / Q000601:surgery*; D012189:Retrospective Studies; D012509:Sarcoma / Q000534:rehabilitation / Q000601:surgery; D013065:Speech Intelligibility / Q000502:physiology; D013524:Surgical Flaps / Q000098:blood supply*; D016896:Treatment Outcome