J Reconstr Microsurg 2017; 33(01): 070-076
DOI: 10.1055/s-0036-1592296
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Comparison of Large Soft Palate Defect Reconstruction Using the New “Tunnel Structure” and Traditional “Port Structure” Methods

Atsumori Hamahata
1   Division of Plastic and Reconstructive Surgery, Saitama Cancer Center, Saitama, Japan
,
Takeshi Beppu
2   Division of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan
,
Takao Tokumaru
2   Division of Head and Neck Surgery, Saitama Cancer Center, Saitama, Japan
,
Takashi Yamaki
3   Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
,
Hiroyuki Sakurai
3   Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

05 May 2016

01 August 2016

Publication Date:
03 October 2016 (online)

Abstract

Background For 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.

Methods From 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.

Results Postoperative 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.

Conclusion The 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.

Funding

None.


 
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