ABSTRACT
For advanced stage tonsil cancer, extensive resection of the soft palate is unavoidable. The purpose of this study is to report on the speech outcome according to the various types of defects and reconstruction techniques. This prospective study was performed on 53 patients of tonsil cancer. The postoperative speech function was evaluated for three factors: nasalance, speech intelligibility, and velopharyngeal insufficiency. Four reconstruction methods used for the soft palate defect: local flap, patch method, Gehanno method, and Denude method. Univariate analysis showed that the Denuded reconstruction technique, more than one-half of the soft palate resection, and T stage was significantly associated for nasalance, speech intelligibility, and velopharyngeal insufficiency. Multivariate analysis showed that the Denuded reconstruction technique (for patients with extensive soft palate and posterior pharyngeal wall defect) was the most significant variable. When the defect of tonsil cancer is extensive, especially when it extends to the posterior pharyngeal wall, a reconstruction method that can reduce the velopharyngeal cross-sectional area efficiently, such as the Gehanno method, is preferred.
Subject(s)
Palate, Soft/surgery , Plastic Surgery Procedures/adverse effects , Speech Intelligibility , Tonsillar Neoplasms/surgery , Velopharyngeal Insufficiency/etiology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Palate, Soft/physiopathology , Prospective Studies , Plastic Surgery Procedures/methods , Speech Acoustics , Surgical Flaps/adverse effects , Treatment Outcome , Velopharyngeal Insufficiency/physiopathologyABSTRACT
Concha bullosa is a common anatomic variation of the middle turbinate; however, sinusitis secondary to the concha bullosa is rare. A 52-yr-old woman presented with nasal obstruction and posterior nasal drip. Computed tomography and examination of the nasal cavity revealed septal deviation on the left side, and a massive concha bullosa and maxillary sinusitis on the right side. The lateral lamella of the affected turbinate was removed and the inspissated material was drained. Histopathologic examination of the excised lesion in the concha bullosa revealed bacterial colonies in the mucus plug. We report here on a massive concha bullosa with secondary maxillary sinusitis.
