title: A Comparison of Large Soft Palate Defect Reconstruction Using the New "Tunnel Structure" and Traditional "Port Structure" Methods.
abstract: BackgroundFor soft palate defects of more than two-thirds, we previously described the bent anterolateral thigh (ALT) method in which the pharyngeal isthmus was reconstructed as a tunnel structure. In this study, we compared the new "tunnel structure" reconstruction in our bent ALT flap method and the traditional "port structure" reconstruction.MethodsFrom April 2010 to March 2015, 25 patients in Saitama Cancer Center (Saitama, Japan) underwent oropharyngeal tumor resection including soft palate resection. In patients who had soft palate resection of less than two-thirds, the Gehanno method was performed in 10 patients (the data were shown as a comparison). In patients who had soft palate resection of more than two-thirds, the pharyngeal isthmus was reconstructed as a tunnel structure using the bent ALT flap method in eight patients and as a port structure in seven patients. The functional outcomes were assessed by interviewing patients about their symptoms and measuring the standard articulation test.ResultsPostoperative function was favorably maintained at equal levels in the tunnel structure reconstruction group and the Gehanno method group at approximately 12 months postoperation. However, in most patients in the port structure reconstruction group, the pharyngeal isthmus became larger after 12 months postoperation and the articulation test was significantly worse than the Gehanno group and the tunnel group.ConclusionThe bent ALT flap method had superior results to the conventional method. Thus the pharyngeal isthmus should be reconstructed as a tunnel structure for patients with soft palate defects of more than two-thirds.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan.
authors.forename: Atsumori
authors.initials: A
authors.lastname: Hamahata
authors.affiliation: Division of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Beppu
authors.affiliation: Division of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Tokumaru
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaki
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakurai
mesh_terms: D000368:Aged; D002972:Cleft Palate / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000503:physiopathology / Q000601:surgery*; D010160:Palate, Soft / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology*; D013524:Surgical Flaps / Q000098:blood supply*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014681:Velopharyngeal Insufficiency / Q000000981:diagnostic imaging*