New Classification System and Defect-Oriented Algorithm for Functional Soft-Palate Reconstruction with Buccinator...

Area of Science:

• Head and Neck Surgery
• Plastic and Reconstructive Surgery
• Oncology

Background:

• Current soft-palate defect classifications lack comprehensive guidance for functional reconstruction.
• Myomucosal flaps demonstrate superiority over fasciocutaneous flaps for palate reconstruction.
• A novel defect-based classification and reconstructive algorithm are proposed.

Purpose of the Study:

• Introduce a new classification system for soft-palate defects.
• Propose a reconstructive algorithm utilizing buccinator myomucosal flaps.
• Guide surgeons toward optimal functional reconstruction of the soft palate.

Main Methods:

• Soft-palate defects classified into five distinct categories.
• Buccinator myomucosal flaps (axial, island, tunnelized variants) employed for reconstruction.
• Evaluation of speech, swallowing, quality of life, and donor-site morbidity; Spearman's rank correlation used.

Main Results:

• All 22 patients achieved favorable speech and swallowing recovery (median deglutition score: 6.04 ± 0.85).
• No severe velopharyngeal insufficiency observed (speech score: 0.36 ± 0.58).
• Satisfactory quality of life and low donor-site morbidity (average score: 8.3) reported.

Conclusions:

• The proposed classification and algorithm offer a user-friendly approach to soft-palate defect reconstruction.
• This system aims to optimize functional outcomes through guided surgical treatment.
• Further multicentric studies are needed to validate findings due to sample size limitations.