Clin Exp Otorhinolaryngol.  2008 Sep;1(3):161-165. 10.3342/ceo.2008.1.3.161.

Functional Benefit after Modification of Radial Forearm Free Flap for Soft Palate Reconstruction

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, Hallym University, College of Medicine, Seoul, Korea. ys20805@chol.com
  • 2Department of Plastic and Reconstructive Surgery, Hallym University, College of Medicine, Seoul, Korea.

Abstract


OBJECTIVES
To compare the velopharyngeal function, swallowing and speech of the conventional and modified radial forearm free flap (RFFF) for soft palate reconstruction.
METHODS
Retrospective clinical study. Twenty-eight patients who underwent oropharyngeal reconstruction with RFFF were divided into two groups: 10 patients had conventional folded RFFF and 18 patients underwent modified method.
RESULTS
The average speech intelligibility score in modified RFFF group was 8.0+/-2.4, and 6.2+/-2.2 in conventional RFFF group (P<0.05). The nasalance was 27.4+/-7.8% in modified group and 38.6+/-2.7% in conventional group during no nasal passage reading and 43.6+/-7.3% in modified group, 55.2+/-7.6% in conventional group during high nasal passage reading (P<0.05). The subjective swallowing functional score was 2.8 in modified group and 2.1 in conventional group.
CONCLUSION
The speech assessment and nasalance demonstrate a more favorable outcome in modified group than conventional group.

Keyword

Radial forearm free flap; Reconstruction; Oropharyngeal cancer; Soft palate

MeSH Terms

Deglutition
Forearm
Free Tissue Flaps
Humans
Oropharyngeal Neoplasms
Palate, Soft
Retrospective Studies
Speech Intelligibility

Figure

  • Fig. 1 Design for conventional radial forearm free flap.

  • Fig. 2 Design for modified radial forearm free flap. Tri-lobed flap of which some portion was de-epithelialized (arrow) and sutured to the remaining soft palate.

  • Fig. 3 (A) Schematic design of modified radial forearm free flap. (B) De-epithelialized area of the flap sutures to the cut end of the soft palate.

  • Fig. 4 The appearance of the oropharynx after surgery in patients with conventional RFFF (A, B) and modified RFFF (C, D). (A) Conventional RFFF after 3 month. (B) Conventional RFFF after 12 month. (C) Modified RFFF after 3 month. (D) Modified RFFF after 12 month. RFFF: radial forearm free flap.


Reference

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