Pedicled Forehead Flap for Palatal Defect Reconstruction: A Novel and Effective Technique

Reconstruction of extensive palatal defects remains challenging, particularly in patients for whom free tissue transfer is contraindicated or has failed. The forehead flap, traditionally used for nasal reconstruction, offers robust vascularity and a long arc of rotation but has rarely been applied to palatal defects. This report introduces a novel application of the supratrochlear artery-based forehead flap for reconstruction of complex palatal defects using transnasal osteotomy-assisted intraoral transfer.

In this report, we present 2 patients with combined hard and soft palate defects successfully reconstructed using a supratrochlear artery-based forehead flap when conventional reconstructive options were not feasible. The flap was transferred intraorally through a surgically created nasal bone window in a staged manner, allowing reliable inset and preservation of flap perfusion.

Functional outcomes, including restoration of oronasal separation, speech, and swallowing, were satisfactory, with acceptable donor-site morbidity.

These cases demonstrate that the forehead flap represents a safe and effective alternative for selected palatal reconstructions and expands its potential indications beyond traditional midfacial applications.