Palatal Island Research Articles

軟口蓋悪性腫よう切除術後の再建における咽頭弁の有用性

We report a case of a malignant tumor at the left side of the soft palate in a 47-year-old man who underwent immediate reconstruction using both a superiorly based pharyngeal flap and a palatal island flap. Velopharyngeal functions were studied with a nasopharyngeal fiberscope one month after operation. The velopharynx, divided into two orifices by the pharyngeal flap, showed complete closure on both deglutition and/p/production, but not on/a/production at the right orifice. One the surgical side, no space between the bulb of a obturator prosthesis and the pharyngeal walls was observed on either deglutition or/p/production, but a very small space was seen on/a/production. A proper amount of space around the obturator reflected the potential for muscular movement related to the production of speech. The defect of the soft palate was restored effectively with the prosthesis, with no loss of function. The usefulness of a pharyngeal flap for reconstruction of acquired lateral soft palate defects was discussed with respect to patients in whom residual velopharyngeal movement is expected.

Oral submucous fibrosis: a new concept in surgical management: Report of 100 cases

Oral submucous fibrosis (OSF) is a collagen disorder commonly seen in the Indian subcontinent. A series of 100 patients is presented. All lesions were biopsied. The condition was staged into four categories. Very early and early cases were treated by local injection of triamicinolone acetonide, while advanced cases were treated by surgical intervention. A new surgical technique of a palatal island flap based on the greater palatine artery in combination with temporalis myotomy and bilateral coronoidectomy was used in 35 cases. A follow-up ranging from 6 months to 3 1/2 years showed good results.

The Palatal Island Flap on Retrospection

The place of the palatal island flap in present-day surgery is evaluated. Attention is drawn to the hitherto unrecognized fact that the first palatal island flap was executed decades before its general introduction in 1962. Its origins are discussed, and the subsequent process from its use as a panacea to the gradual evolution of its indications is described. Variations in anatomy, complications, success rates, and contraindications are reviewed. Attention is paid to the problems inherent in studies of palate surgery, both retrospective and prospective. A balance is made up of what has and has not been proven adequately. To date, no advantages over other palate-lengthening procedures have been established, while there is some evidence that it might in fact be deleterious to maxillary growth. As a result, at present, the palatal island flap is used mainly in closure techniques, as in fact was done by the first two surgeons using that it more than half a century ago.

口蓋島状弁による臼後三角部悪性腫瘍再建の 1 症例

口蓋島状弁による臼後三角部悪性腫瘍再建の 1 症例

口蓋島状弁による口腔粘膜再建の検討

The palatal island flap technique (the vascular pedicled mucoperiosteal island flap) has been reported to be useful for the reconstruction of the defect in the oral region.The purpose of this study is to investigate the procedure and the wound healing of the donor site, and the postoperative sensorial recuperation of donor and recipient sites.10 cases reconstructed with palatal island flap were examined.The largest defect was 40×40 mm and the smallest one was 5×10 mm.To donor sites, skin graft, fibrinoplastic agents, lyophilized porcine skin, or atelocollagen were applied, and reepithelizing terms were measured.Postoperative sensorial recuperation of donor and recipient sites appeared perfectly in two years.In conclusion, this technique was found to be useful for the reconstruction of oral mucosa, because of technical ease and least disturbance.

Secondary closure of oroantral and oronasal fistulas: A modification of existing techniques

Fifty-three patients, 25 with oroantral and 28 with oronasal fistulas, were treated using a modified technique of peripheral de-epithelialization and overlapping flaps. This technique was used with sliding buccal flaps, palatal rotation flaps, palatal island flaps, tongue flaps, and distant tubed pedicle flaps. The advantage of the flap is that it provides more tissue attachment, which promotes healing and resists the tendency of the flap to return to its original position. A high degree of success can be predicted. Only two failures were observed in 53 cases.

口蓋島状弁により再建を行った口蓋腫ようの２例

An application of a palatal island flap to reconstruction of a defect following excision of a palatal tumor in two cases is reported. The first case was a 55-year-old man with a malignant tumor of salivary gland origin on the right side of the soft palate. An excision of the tumor resulted in formation of a large defect approximately 30mm in diameter with communication to the nasal cavity. The defect was closed by posterior rotation of a mucoperiosteal island flap which was elevated from the anterior portion of the ipsilateral palate, The postoperative course was uncomplicated, but slight velar dysfunction remained postoperatively due to scar contraction of the flap. In the second case, an oronasal fistula of 9× 5mm in size developed following excision of a pleomorphic adenoma in the posterior portion of the right hard palate. The fistula was successfully closed by a mucoperiosteal palatal flap elevated from the contralateral side without leaving functional disturbance.In conclusion, the flap was found to be useful for reconstruction of palatal defects of varing sizes an locations because of good blood supply, extensive mobility, technical easiness and least aesthetic disturbance.

口蓋弁による軟口蓋再建の２例

Two cases of immediate reconstruction using palatal flap for defect following excision of the soft palatal tumor were reported.A reconstruction for palatal defect of the soft palate using palatal island flap was very useful in following advantages. The flap was able to transfer from adjacent hard palate. There were no functional disturbances in the hard palate and no necrosis of the flap because of excellent blood supply. The flap was very movable so that it could transfer even to posterior border of the soft palate. This procedure which could achieve in only one stage without delay was easier than in other flaps.On the other hand, in a reconstruction for defect of the entier soft palate, atrophy of the flap was remarkable after 2 or 3 months so that it should be simultaneously used with pharyngeal flap.

Extended palatal island mucoperiosteal flap.

The extended palatal island mucoperiosteal flap was used in 53 cases over a ten-year period. Its many uses include reconstruction of the soft palate and resurfacing of retromolar and cheek defects. Its reliability with a success rate of 96% and spontaneous epithelialization of the donor site at three months makes it an attractive method of reconstruction.

Palatal Island Flap for Reconstruction of Oral Defects

This communication describes the technique of the palatal island flap and its usefulness in intraoral reconstruction, with a modification for increasing its extension by means of the palatine foramen free-up procedure. The other modalities, with their attendent advantages and disadvantages for intra-oral reconstruction, are briefly reviewed.

The versatile palatal island flap: Its use in soft palate reconstruction and nasopharyngeal and choanal atresia

The mucoperiosteal island flap, first designed to provide nasal lining during pushback lengthening of a short cleft palate, has been used to assist in reconstruction of large soft palate defects following resection for cancer, to create and maintain patency of the velopharyngeal aperture after stenosis and to maintain patency of the nasal airway after resection of bony choanal atresia.

The palatal island flap in the closure of oro-antral fistulae

The use of palatal island flaps in the treatment of oro-antral fistulae is described, and a two-stage method for the closure of large oro-antral defects discussed. The method can be readily adapted to smaller lesions and to those where intermediate inspection is unnecessary by telescoping the two stages into one. An illustrative case is presented which raises most of the points of discussion likely to centre round this technique.