Soft palate reconstruction after tumor resection using free radial forearm flap – results from 44 cases

Introduction:

Lack of soft palate leads to nasal regurgitation, even to the impossibility of oral nutrition. Therefore, primary reconstruction after tumor resection, especially in functional terms, is very important. The free radial forearm flap (radialis Tx) is very well suited for this purpose because of its good formability due to the small thickness.

Methods:

For this descriptive retrospective study, we reviewed the management of all patients who received soft palate reconstruction using radialis Tx in our clinic over the last four years. The data were evaluated for functional and oncological outcome and local tumor control.

Results:

During this period, 44 soft palate reconstructions were performed using radialis Tx. Thirty patients were in UICC stadium III or IV at the time of surgery. In 14 cases, the entire soft palate was reconstructed and in 30 cases up to 2/3 of the soft palate. In more than 90% of patients (n = 40) a complete and permanent oral nutrition was possible 3 weeks after surgery. In the remaining 4 patients this was not possible even after 3 months. All of these patients had a T3 tumor and one patient additionally had a Korsakow syndrome. In the average follow-up period of 19 (± 13) months, 5 patients developed local recurrence. 3 patients died of distant metastases. One patient did not die from tumor.

Conclusion:

Tumor resection in the region of the soft palate, followed by reconstruction using microvascular anastomosed radialis Tx, provides an oncologically safe procedure with a good functional outcome even in larger tumor stages.

Publication History

Publication Date:
23 April 2019 (online)