TY - JOUR
T1 - Soft palate reconstruction after radionecrosis
T2 - Combined anterolateral thigh adipofascial and nasoseptal flaps
AU - Zenga, Joseph
AU - Sharon, Jeffrey D.
AU - Gross, Jennifer
AU - Gantz, Jay
AU - Pipkorn, Patrik
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/8
Y1 - 2018/8
N2 - 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.
AB - 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.
KW - Anterolateral thigh flap
KW - Nasopharyngeal cancer
KW - Nasoseptal flap
KW - Oropharyngeal reconstruction
KW - Radionecrosis
UR - http://www.scopus.com/inward/record.url?scp=85034594093&partnerID=8YFLogxK
U2 - 10.1016/j.anl.2017.11.003
DO - 10.1016/j.anl.2017.11.003
M3 - Article
C2 - 29146179
AN - SCOPUS:85034594093
SN - 0385-8146
VL - 45
SP - 875
EP - 879
JO - Auris Nasus Larynx
JF - Auris Nasus Larynx
IS - 4
ER -