Reconstruction of a Total Soft Palatal Defect Using a Folded Radial Forearm Free Flap and Palmaris Longus Tendon Sling
Archives of Plastic Surgery
;
: 25-30, 2012.
Article
in English
| WPRIM
| ID: wpr-107376
ABSTRACT
BACKGROUND:
The soft palate functions as a valve and helps generate the oral pressure required for normal speech resonance. Speech problems and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. We suggest a large volume folded free flap for reduction of the caliber and a palmaris longus tendon sling for suspension of the reconstructed palate.METHODS:
Six patients had total soft palate resection for tonsillar cancer and reconstruction with a large volume folded radial forearm free flap combined with a palmaris longus sling. A single surgeon and speech therapist examined the patients with three standardized speech assessment tools nasometer test, consonant articulation test, and speech acuity test performed for speech evaluation.RESULTS:
Mean nasalance score was 76.20% for sentences with nasal sounds and 43.60% for sentences with oral sounds. Hypernasality was seen for oral sound sentences. The mean score of the picture consonant articulation test was 84% (range, 63% to 100%). The mean score of the speech acuity test was 5.84 (range, 5 to 6). These mean ratings represent a satisfactory level of speech function.CONCLUSIONS:
The large volume folded free flap with a palmaris longus tendon sling for total soft palate reconstruction resulted in satisfactory prognosis for speech despite moderate hypernasality.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Palate, Soft
/
Prognosis
/
Tendons
/
Tonsillar Neoplasms
/
Free Tissue Flaps
/
Forearm
Type of study:
Prognostic study
Limits:
Humans
Language:
English
Journal:
Archives of Plastic Surgery
Year:
2012
Type:
Article
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