Abstract
5 year crude survival rates of the patients with cancer of the hard palate, upper gingiva and upper gingivobuccal sulcus which were treated by combination therapy consisting of Linac X ray irradiation (2Gy×18), intraarterial chemotherapy (5FU, 250mg×18) and radical surgery with primary reconstruction if necessary were 11/14, 8/10, and 4/6 respectively. Although no patients with cancer of the hard palate died of original cancer, 3 out of 4 treatment failures in cancer of the upper gingiva and upper gingivobuccal sulcus were due to local recurrences. In 22 patients who had reconstruction of the hard palate using various methods after extensive resection of the hard palate together with upper gingiva, the effect of difference of reconstruc tive methods on postoperative oral functions were evaluated. By complete closure of the palatine defects by any methods, both articulatory and swallowing dysfunctions could be fully prevented in all cases. However the palates reconstructed with soft tissue such as DP flap and free myocutaneous flap tended to droop with undesirable cheek contour. Wearing of the effective dentures were impossible in all edentulous patients in whom more than 2/3 of the hard palate had been resected. The rigid palates without drooping could be reconstructed by using the osteocutaneous scapular flap in 2 cases which could also restore desirable cheek contour. However, as for postoperative masticatory function, advantage of reconstruction of the rigid palate were not obvious due to difficulty of wearing of the dentures in these cases.
