The folded radial forearm flap in soft-palate and tonsillary fossa reconstruction: technical note.
Excision of the tonsillary fossa and soft palate leaves functional sequelae unless followed by a well-planned reconstruction phase. This must aim at restoring the pharyngeo-palatal structure, covering the dissected surfaces, and restoring continuity to the lingual and inferior alveolar nerves when these are sectioned. A reconstruction model of this complex three-dimensional anatomical area is proposed that uses a microvascular fasciocutaneous forearm flap adapted to the individual patient. Twelve patients were operated on, following this model. All flaps survived intact. Velopharyngeal function was optimal in 11 cases (92%), suboptimal in 1 case. Patients also achieved good functional recovery (speech, swallowing and chewing). Careful three-dimensional planning of reconstruction for the tonsillary and soft-palate area makes it possible to restore velopharyngeal function to levels close to the preoperative situation.
Biglioli
F
F
Division of Maxillofacial Surgery, San Paolo University Hospital, Milan, Italy. federico.biglioli@unimi.it
Brusati
R
R
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D005542:Forearm; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery*; D013065:Speech Intelligibility; D013524:Surgical Flaps; D016896:Treatment Outcome