Soft palate reconstruction after radionecrosis: Combined anterolateral thigh adipofascial and nasoseptal flaps. Auris Nasus Larynx 2018 Aug;45(4):875-879
Date
11/18/2017Pubmed ID
29146179DOI
10.1016/j.anl.2017.11.003Scopus ID
2-s2.0-85034594093 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
Although radiation-based treatment for nasopharyngeal cancer may achieve excellent long term oncologic results, late effects of therapy may lead to soft tissue radionecrosis and velopharyngeal insufficiency (VPI). Repair of these oro- and nasopharyngeal defects presents a complex reconstructive challenge. We present a case of a long-term survivor treated with chemoradiotherapy for nasopharyngeal cancer who developed progressive dysphagia, velopharyngeal insufficiency, and radionecrosis of the nasopharynx and soft palate, leading to tracheostomy and gastrostomy tube dependence. A staged reconstruction was performed, initially with a tubed nasoseptal flap for a creation of a mucosal-lined nasopharyngeal port. An adipofascial anterolateral thigh free flap was subsequently performed for soft palate reconstruction. Within 2 months, the oropharyngeal reconstruction had remucosalized and she was decannulated, taking an oral diet. Her speech was intelligible and she had good nasal breathing without symptoms of velopharyngeal insufficiency.
Author List
Zenga J, Sharon JD, Gross J, Gantz J, Pipkorn PAuthor
Joseph Zenga MD Associate Professor in the Otolaryngology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Adipose TissueAdult
Carcinoma
Chemoradiotherapy
Fascia
Female
Free Tissue Flaps
Humans
Nasal Septum
Nasopharyngeal Neoplasms
Nasopharynx
Necrosis
Otorhinolaryngologic Surgical Procedures
Palate, Soft
Radiation Injuries
Surgical Flaps
Thigh
