Techniques and outcomes in microsurgical soft palate reconstruction

Introduction: The soft palate is a multilayered intrinsically mobile structure, with a critical role in maintaining the airway, swallowing, and speech. We describe our technique of microsurgical reconstruction and analyze patient reported outcomes. Methods: A retrospective analysis was performed using the University of Washington head and neck disease specific Quality of Life (UWQOL) questionnaire and the Hirose Standard speech analysis tool. Swallowing function and diet were recorded. Results: Twenty cases were reviewed; nine were available for post hoc analysis. Anterolateral thigh flaps were used in 19 cases, in combination with vastus lateralis muscle in 5 cases. Speech intelligibility was graded “excellent” in 8 of 9 cases and moderate in 1 of 9. All tolerated an oral diet. Mean UWQOL score was 424.4/600 (SD ± 141.9) for physical and 461.7/600 (SD ± 141.9) for emotional-social domains. Conclusion: Reconstruction of the soft palate using velopharyngeal narrowing with free anterolateral thigh flap delivers good functional outcomes.