The Observation Of The Efficacy To Repair The Palate Penetrating Defect With The Palatal Island Mucoperiosteal Flap

Objective:Palate tumors accounted for2to5of the oral and maxillofacialtumors，and the incidence of Palate malignant tumors accounted for10%of oral cancer.At present,Surgical resection is still the main methods to treat the palate malignanttumor. Palatal malignant tumor such as squamous cell carcinoma andmucoepidermoid carcinoma，more Located in the soft and hard palate junction andinvolved one side of the greater palatine artery. On the palate and maxillary would becompressed, deformed, eroded and damaged. We should expand the resection part ofmaxilla and palate bone to avoid the simple simple resection of easy to relapse. Becauseof some of the teeth, maxilla and palate bone loss,these will lead to the oralnasopharyngeal lumen, result in slurred speech, chewing and swallowing difficultiesphysiological dysfunction.There will give a patient psychology brings certain pressureand affect quality of life. The management of palatal defects resulting from themalignant lesions uses a variety of methods,with the optimal techniques allowingmaximal postoperative function with minimal morbidity. The palate island flap is aneffective,reliable technique for reconstructing option. This paper discusses thefollow-up data in the palate island flap repair the palate penetrating defect after thepalate malignant tumor application value in First Affiliated Hospital of Dalian MedicalUniversity,oral and maxillofacial surgery Department. Observe the effect of the wholepalatal island flap to repair the defect.Material and methods:Retrospective analysis data of24patients who underwentwas done where in surgery was performed for palatal malignant tumors followed bysubsequent primary reconstruction using palatal island flaps,were collected in FirstAffiliated Hospital of Dalian Medical University，oral and maxillofacial surgeryDepartment from January2006to December2011. Pathology is mucoepidermoid carcinoma or squamous cell carcinoma. All the cases included tumor invasion on onlyone side of the palate.Wide local excision of the tumor and removal of the invading artery, ipsilateralpalate and nasal mucosa leading to formation of the oral fistula. The contralateral arterywas used as a vascular pedicle to raise the palatal island flap. The artificial mucousmembrane was used on the nasal aspect of the defect to protect the blood vessels on theflap. The island flap is then rotated more than90degrees into the defect. The exposedbone on the donor site is also covered with the artificial mucous membrane followed bytie-over bolster dressing for the mucosal graft.Results: The flaps in all the cases survived well with good post-operative healingand no oro-nasal communication except one case where in the flap failed due to aninjury to the artery (supplying the flap) intra-operatively. The patients were all deniedthatthere have obvious difference with preoperation in eating, pronunciation.After4-6weeks, the donor area was covered completely by the mucosa.Conclusion:The palatal island flap is relatively simple, practical and easy to graspmethod for repairing palate penetrating defect. The palatal island flap is the idealmethod to repair the smaller palate penetrating defect.