Soft palate reconstruction with free jejunum flap: Impact on the velopharyngeal insufficiency

If inadequately reconstructed, large resections of the soft palate inevitably cause velopharyngeal insufficiency, nasal regurgitation and reduce speech intelligibility. A series of 12 free Jejunal flaps are presented, with 28.5 months median follow up (IQR 10.5), with evidence that the flaps provided appropriate secretions and good functionality for speech and resumption of oral intake. A retrospective case series was performed, from 2004 to 2020, including patients diagnosed with palate locally advanced squamous cell carcinoma and reconstructed with free jejunum flap. Twelve patients were included, with mean age of 66 years. No flap loss, thrombosis or infection were recorded. Oral feeding was achieved in all patients, on an average after 36 days from the operation. Speech intelligibility improved by 4 points in a scale 0-10. The thin, pliable, and elastic properties of the free jejunal flap are optimally suited for a functional reconstruction of the three-dimensional palatal defects. With its serous and mucous secretion, the free jejunal flap can lead to early return to solid diet and minimize functional impairment of phonation and speech.