The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection
Summary:. Total soft palate reconstruction is a challenge for the head and neck surgeon. Velopharyngeal incompetence resulting from soft palate resection impairs both speech and swallowing and significantly affects the quality of life of the patients. Radial forearm free flap is the reconstructive t...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-10-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004531 |
| _version_ | 1797991592453210112 |
|---|---|
| author | Olindo Massarelli, MD, PhD, FEBOMFS Claudio Carnevale, MD |
| author_facet | Olindo Massarelli, MD, PhD, FEBOMFS Claudio Carnevale, MD |
| author_sort | Olindo Massarelli, MD, PhD, FEBOMFS |
| collection | DOAJ |
| description | Summary:. Total soft palate reconstruction is a challenge for the head and neck surgeon. Velopharyngeal incompetence resulting from soft palate resection impairs both speech and swallowing and significantly affects the quality of life of the patients. Radial forearm free flap is the reconstructive technique most used worldwide, but it requires microsurgical skills, is associated with high donor site morbidity, and shrinks during the healing process, especially after adjuvant radiotherapy. We present a novel technique using a single “kite-shaped” tunnelized-facial artery myomucosal island flap (t-FAMMIF) and report very favorable functional outcomes. Three patients in whom a kite-shaped flap was used to reconstruct a total soft palate defect after squamous cell carcinoma resection were included. In two of them, the resection included both tonsils due to cancer spreading to the tonsillar fossae. The mucosal and muscular sides of a single t-FAMMIF flap were able to restore the oral and nasal lining of the palate, respectively, without the need to fold the flap. All patients were able to tolerate an oral soft diet 10 days after surgery. No complications were detected. A complete mucosalization on the nasal lining was observed by video-endoscopy 3 weeks after surgery. No case of shrinking of the flap was observed during the follow-up, and speech and swallowing functions were not impaired after complete wound healing. Kite-shaped t-FAMMIF represents an excellent and feasible reconstructive option for extensive postablative soft palate defects. |
| first_indexed | 2024-04-11T08:54:40Z |
| format | Article |
| id | doaj.art-fe6b02f0dce045a9860d8e2c8d30d00c |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-11T08:54:40Z |
| publishDate | 2022-10-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-fe6b02f0dce045a9860d8e2c8d30d00c2022-12-22T04:33:20ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-10-011010e453110.1097/GOX.0000000000004531202210000-00025The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate ResectionOlindo Massarelli, MD, PhD, FEBOMFS0Claudio Carnevale, MD1From the * Department of Mental Health and Sense Organs, Maxillofacial Surgery Operative Unit, Santa Maria Le Scotte, University Hospital of Siena, Italy† Department of Otorhinolaryngology Head and Neck Surgery, Son Espases University Hospital, Palma de Mallorca, Spain.Summary:. Total soft palate reconstruction is a challenge for the head and neck surgeon. Velopharyngeal incompetence resulting from soft palate resection impairs both speech and swallowing and significantly affects the quality of life of the patients. Radial forearm free flap is the reconstructive technique most used worldwide, but it requires microsurgical skills, is associated with high donor site morbidity, and shrinks during the healing process, especially after adjuvant radiotherapy. We present a novel technique using a single “kite-shaped” tunnelized-facial artery myomucosal island flap (t-FAMMIF) and report very favorable functional outcomes. Three patients in whom a kite-shaped flap was used to reconstruct a total soft palate defect after squamous cell carcinoma resection were included. In two of them, the resection included both tonsils due to cancer spreading to the tonsillar fossae. The mucosal and muscular sides of a single t-FAMMIF flap were able to restore the oral and nasal lining of the palate, respectively, without the need to fold the flap. All patients were able to tolerate an oral soft diet 10 days after surgery. No complications were detected. A complete mucosalization on the nasal lining was observed by video-endoscopy 3 weeks after surgery. No case of shrinking of the flap was observed during the follow-up, and speech and swallowing functions were not impaired after complete wound healing. Kite-shaped t-FAMMIF represents an excellent and feasible reconstructive option for extensive postablative soft palate defects.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004531 |
| spellingShingle | Olindo Massarelli, MD, PhD, FEBOMFS Claudio Carnevale, MD The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection Plastic and Reconstructive Surgery, Global Open |
| title | The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection |
| title_full | The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection |
| title_fullStr | The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection |
| title_full_unstemmed | The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection |
| title_short | The “Kite-t-FAMMIF”: A Novel Technique for Reconstruction of Extensive Soft Palate Resection |
| title_sort | kite t fammif a novel technique for reconstruction of extensive soft palate resection |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004531 |
| work_keys_str_mv | AT olindomassarellimdphdfebomfs thekitetfammifanoveltechniqueforreconstructionofextensivesoftpalateresection AT claudiocarnevalemd thekitetfammifanoveltechniqueforreconstructionofextensivesoftpalateresection AT olindomassarellimdphdfebomfs kitetfammifanoveltechniqueforreconstructionofextensivesoftpalateresection AT claudiocarnevalemd kitetfammifanoveltechniqueforreconstructionofextensivesoftpalateresection |