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

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Reconstructing extensive palatal defects is challenging, especially when free tissue transfer is not an option.
• The forehead flap, known for its vascularity and rotation, is rarely used for palatal reconstruction.
• This study explores a novel use of the supratrochlear artery-based forehead flap for palatal defects.

Purpose of the Study:

• To introduce and evaluate a novel technique for palatal defect reconstruction using a forehead flap.
• To assess the feasibility and outcomes of transnasal osteotomy-assisted intraoral transfer of the forehead flap for complex palatal defects.

Main Methods:

• A supratrochlear artery-based forehead flap was utilized for reconstruction in two patients with combined hard and soft palate defects.
• The flap was transferred intraorally through a surgically created nasal bone window in a staged procedure.
• This method ensured reliable inset and maintained flap perfusion.

Main Results:

• Successful reconstruction of combined hard and soft palate defects was achieved in both patients.
• Functional outcomes, including oronasal separation, speech, and swallowing, were satisfactory.
• Donor-site morbidity was acceptable.

Conclusions:

• The forehead flap is a safe and effective alternative for selected palatal reconstructions.
• This technique expands the reconstructive potential of the forehead flap beyond its traditional applications.
• Transnasal osteotomy-assisted intraoral transfer provides a viable approach for complex palatal defects.