Soft palate reconstruction after radionecrosis: Combined anterolateral thigh adipofascial and nasoseptal flaps

Zenga, Joseph; Sharon, Jeffrey D.; Gross, Jennifer; Gantz, Jay; Pipkorn, Patrik

doi:10.1016/j.anl.2017.11.003

Cited by 6 publications

(2 citation statements)

References 12 publications

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“…In contrast, there were several ways to reconstruct the nasal aspect with epithelial tissue (a two-layer closure). These are folding free flaps, sandwich flaps, 2 pharyngeal flaps, 3 nasoseptal flaps, 4 inferior turbinate flaps, 5 and skin grafts. 6 Although every case report with or without epithelial flaps for nasal lining reconstruction has had good results, the number of cases was too small to discuss the meaning of a two-layer closure.…”

Section: Discussionmentioning

confidence: 99%

Two-Layer Palatal Reconstruction Reduces Postoperative Intraoral Complications in Head and Neck Surgery

Nemoto

Cheong

Hung

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Although microvascular free flaps are commonly performed and have high success rates, postoperative oronasal fistulas or infections do occur. The authors hypothesized that a two-layer closure is effective for prevention of intraoral complications. Methods: Patients who underwent palatal reconstruction with a microvascular free flap were evaluated retrospectively. The cases were divided into two groups (palatal reconstruction with or without a two-layer closure). A two-layer closure involves unilateral reconstruction with a free flap, then reconstruction of the nasal lining with a local flap or folding free flap. The postoperative complication rates between these two groups were compared. Results: One hundred fifty-five cases were evaluated. A two-layer closure was performed in 65 cases (41.9 percent). The incidence of infections, dehiscence of the recipient site, and oronasal fistula were significantly higher in the single-layer closure group than in the two-layer closure group [10.0 percent versus 0 percent (p = 0.011); 15.6 percent versus 4.6 percent (p = 0.036); and 17.8 percent versus 4.6 percent (p = 0.013), respectively]. Conclusions: A two-layer closure in palatal reconstruction was shown to reduce the rate of infection, intraoral wound dehiscence, and oronasal fistula in the current study. A two-layer closure provides greater support and stability and reduces the risk of failure in reconstruction of the palate with a microvascular free flap. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

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Section: Discussionmentioning

confidence: 99%

Two-Layer Palatal Reconstruction Reduces Postoperative Intraoral Complications in Head and Neck Surgery

Nemoto

Cheong

Hung

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…37 Another study reported use of the nasoseptal flap to create a tube mucosal lined nasopharyngeal port followed by microvascular free flap reconstruction of the soft palate. 38 Microvascular free flap reconstruction is also another option in pharyngeal defect reconstruction. This may be particularly useful when other techniques have failed or when a large tissue deficit exists.…”

Section: Reconstructionmentioning

confidence: 99%

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity

London

Chan

Carrau

2020

Seminars in Plastic Surgery

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Multiple anterior surgical approaches are available to obtain access to the nasopharynx, clivus, and craniocervical junction. These include the direct and transoral robotic surgery transpalatal, maxillary swing, and endoscopic endonasal approaches. In this article, we describe the indications for these techniques, surgical steps, and associated morbidities. This article is a PubMed literature review. A review of the literature was conducted to assess the techniques, surgical steps, and associated morbidities with transpalatal approaches to the skull base and nasopharynx. The transpalatal approach has been traditionally utilized to obtain surgical access to the nasopharynx, clivus, and craniocervical junction. Morbidity includes velopalatine insufficiency due to shortening of the soft palate from scar contraction or neuromuscular damage, thus leading to hypernasal speech and dysphagia. Middle ear effusion and oronasal or oronasopharyngeal palatal fistula are additional potential morbidities. The choice of surgical approach depends on a variety of factors including the disease location and extent, surgeon experience, and available resources.

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Excision of Palatal Neoplasms

Slijepcevic,

Petrisor,

Wax

2024

Springer Surgery Atlas Series

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Soft palate reconstruction after radionecrosis: Combined anterolateral thigh adipofascial and nasoseptal flaps

Cited by 6 publications

References 12 publications

Two-Layer Palatal Reconstruction Reduces Postoperative Intraoral Complications in Head and Neck Surgery

Two-Layer Palatal Reconstruction Reduces Postoperative Intraoral Complications in Head and Neck Surgery

Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity

Excision of Palatal Neoplasms

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