Total Soft Palate Reconstruction Using Tri-lobed Radial Forearm Free Flap after Wide Excision-A Case Report

Background: Soft palate reconstruction of oropharyngeal cancer is a therapeutic challenge. Speech problem and nasal regurgitation can result from a soft palatal defect. Reduction of the size of the velopharyngeal orifice is required to compensate for the lack of mobility in a reconstructed soft palate. Although various methods can be used for reconstruction of soft palate defects, it is difficult to obtain satisfactory results from the perspective of the functional restoration of the soft palate. Aim and Objectives: We aim to restore the normal palatal anatomy and provide the valve structure to improve postoperative velopharyngeal insufficiency. Materials and Methods: A case of a 74-year-old male with soft palate squamous cell carcinoma (T3N0M0 stage III) underwent wide excision and modified radical neck dissection. A large volume of tri-lobed radial forearm free flap (RFFF) was folded like neo-uvula and inset the defect. Results: The postoperative course was uneventful, within 18 months, and he was able to tolerate swallowing function and exhibited understandable speech quality. Conclusion: Tri-lobed RFFF reconstruction for large soft palate defect after oncologic surgery resulted in satisfactory prognosis for restore velopharyngeal function and it was a feasible option for large soft palate defect reconstruction.