Abstract
The Gehanno method, in which the posterior pharyngeal wall is sutured to the posterior surface of the remaining soft palate, is popular in reconstruction after wide resection of the lateral and superior oropharyngeal wall. However, it is difficult in case of total resection of the soft palate because of loss of the remaining soft palate. Our method of velopharyngeal plasty for such cases is to make an incision in the posterior pharyngeal wall from the cut end of the palatopharyngeal muscle caudally and to suture both sides of the posterior pharyngeal wall to partially form a tube shape. We performed this velopharyngeal plasty for a patient with oropharyngeal squamous cell carcinoma in stage T3N3M0; after total resection of the soft palate, we covered the exposed muscles and the resection defect with a free flap. He was able to eat without tube feeding and so the tracheal stoma was closed, and he began to undergo postoperative chemoradiotherapy after one month. He is alive without disease, and his velopharyngeal function has been good for 30 months after surgery.
