title: Reconstruction of soft plate necrosis after endotracheal intubation.
abstract: Uvular necrosis after long-term endotracheal intubation has been previously reported, but there have been no reports regarding soft palate necrosis after endotracheal intubation. Recently, we encountered 2 patients who had a high degree of soft palate necrosis following endotracheal intubation during long-term care in the intensive care unit. This study reports noncongenital soft palate cleft caused by endotracheal intubation. Two patients, aged 30 and 38 years, with noncongenital cleft palate were treated with pharyngeal flap and/or palatoplasty at our institution from March 2011 to May 2013. Initially, the patients complained of acquired speech disorder and severe oronasal regurgitation caused by a palatal defect. Speech ability was evaluated preoperatively and postoperatively by a perceptual language test and nasopharyngoscopy. The cleft soft palates of both patients were completely repaired, and the aforementioned symptoms improved after surgery. Postoperative courses were uneventful in both of the cases, and neither patient experienced a recurrence. Although rare, long-term intensive care unit care with endotracheal intubation can cause noncongenital soft palate cleft. In cases with iatrogenic cleft palate that does not heal with conservative treatment, surgical procedures such as pharyngeal flap and palatoplasty can be helpful.
authors.affiliation: From the Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyuck Jae
authors.initials: HJ
authors.lastname: Lee
authors.forename: So Young
authors.initials: SY
authors.lastname: Lim
authors.forename: Jai-Kyong
authors.initials: JK
authors.lastname: Pyon
authors.forename: Goo Hyun
authors.initials: GH
authors.lastname: Mun
authors.forename: Sa Ik
authors.initials: SI
authors.lastname: Bang
authors.forename: Kap Sung
authors.initials: KS
authors.lastname: Oh
mesh_terms: D000328:Adult; D002972:Cleft Palate / Q000473:pathology* / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D008134:Long-Term Care; D008297:Male; D009336:Necrosis; D010160:Palate, Soft / Q000473:pathology* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery; D014609:Uvula / Q000473:pathology* / Q000601:surgery*; D014681:Velopharyngeal Insufficiency / Q000601:surgery*