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Reconstruction of a total soft palatal defect using a folded radial forearm free flap and palmaris longus tendon sling

 Myung Chul Lee ; Dong Won Lee ; Dong Kyun Rah ; Won Jai Lee 
 Archives of Plastic Surgery, Vol.39(1) : 25~30, 2012 
Journal Title
 Archives of Plastic Surgery 
Issue Date
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. KEYWORDS: Free tissue flaps, Palate, soft, Speech
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1. 연구논문 > 1. College of Medicine > Dept. of Plastic Surgery & Reconstructive Surgery
Yonsei Authors
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