1996 Volume 45 Issue 1 Pages 72-79
Reconstruction of the surgical defect of the soft palate and lateral oropharyngeal wall is complicated and frequently results in velopharyngeal dysfunction. In this paper, a simple and reliable reconstructive method of the soft palate and lateral oropharyngeal wall is described and the postoperative function of the patients who underwent reconstruction is evaluated.
The soft palate is reconstructed by developing a plane between the prevertebral fascia and superior pharyngeal constrictor in the oropharyngeal resection margin. The pharyngeal myomucosal flap is mobilized and sutured to the posterior edge of the hard palate and remaining soft palate, resulting in reconstruction of a smaller velopharyngeal space. Then the faucial arch is narrowed by suturing the edge of posterior pharyngeal wall to the tongue base. Lastly, the exposed muscle of the pharyngeal constrictor and other surgical defects are covered with a forearm flap or myocutaneous flap.
During the past 15 years, we performed this reconstructive procedure on 15 patients with carcinoma of the oral cavity or oropharynx. All of these patients had the surgical defect of one- to two-thirds of the soft palate combined with the lateral oropharyngeal wall.
After reconstruction, 14 patients had normal nasal air and swallowing without aspiration. Slight nasal regurgitation of liquids with swallowing developed in 4 patients. Postoperative articulatory dysfunction resulting from velopharyngeal insufficiency was within the acceptable range.
This reconstructive procedure is easy to carry out and preserves the important function of the soft nalate.
