Background and Objective : Soft palate plays a great role in function of speech and
swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft
palate in most cases and restoration of the postoperative oral cavity function is a
continuing surgical challenge. Although a variety of techniques are available, radial
forearm free flap has been known as an effective method for these defect, which offers
a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the
present study is to report the speech and swallowing function test results of our 5
consecutive radial forearm free flaps used for tonsil cancers.
Materials and Methods : We reviewed the medical records of 5 patients who were
offered intraoral reconstruction with a radial forearm free flap after ablative surgery for
tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods,
complications, and speech and swallowing function test results. We have examined with
modified barium swallow to evaluate postoperative wallowing function and articulation
and resonance test for speech.
Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3).
The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed
design and in variable size from 24㎠ to 108㎠(average size = 78.4㎠), according to the
defect after ablation. This procedures resulted in satisfactory flap success and functional
results all but 1 case of flap contracture in 2 postoperative week, achieved early oral
diet until 16-57 postoperative day(average, 28 days) and social speech. The
oropharyngeal defect including soft palate reconstruction with radial forearm free flap
might be an excellent method for the maximal functional results, after ablative surgery
of tonsil cancer that results in multidimensional defect.
|