• The Journal of Korean Academy of Prosthodontics
• /
• v.37 no.1
• /
• pp.134-138
• /
• 1999

연구개는 그 주위조직과 더불어 생리적 기능에 있어 음성, 연하, 및 호흡 등에 중요한 역할을 한다. 종양등의 이유로 인한 연구개의 외과적 절제는 그 해부학적 크기와 모양의 영구적인 변화로 인해 여러기능의 상실을 초래한다. 이에 따른 결함은 과도한 비음, 연하중 음식물이나 유동물의 비관으로의 누출 등을 들 수 있다. 연구개와 그 주위조직의 생리적인 기능의 숙지 및 이를 응용한 보철물(Palatopharyngeal Obturator)의 적절한 제작은 이러한 기능적 결함을 수복하는데 이용되어진다. 본 증례에서는 종양으로 인해 연구개를 절제한 환자의 보철적 수복에 있어, 구강내 온도에 따라 그 형상이 변화하는 인상재를 이용하여, 측-후 인두벽의 운동을 기능적으로 인기하는 방법을 이용하였다. 이러한 방법으로 제작된 보철물은 종양으로 인한 연구개의 절제 후 생리적인 기능의 장애를, 올바른 Palatopharyngeal 폐쇠를 유도함으로써 음질의 향상, 연하등의 기능을 회복시키는데 큰 도움이 될 수 있음을 보여준다.

• Archives of Craniofacial Surgery
• /
• v.11 no.1
• /
• pp.53-57
• /
• 2010

Purpose: The radial forearm fasciocutaneous free flap is currently considered as the ideal free flap for reconstruction of mucosal and soft tissue defects of the palate. But the availability of stably attached oral and nasal mucosal lining is needed. In addition to this, for better operation field, operating convenience and esthetics, we planned a prelaminated radial forearm free flap. Methods: A 64-year-old male patient was admitted due to a $4{\times}4.5cm$ full through defect in the middle of the hard palate caused by peripheral T cell lymphoma with actinomycosis. In the first stage, the radial forearm flap was elevated, tailored to fit the hard palate defect, and then it positioned up-side down with split thickness skin graft. Two weeks later, the prelaminated radial forearm free flap was re-elevated and transferred to the palatal defect. One side covered with grafted skin was used to line the nasal cavity, and the other side (the cutaneous portion of the radial forearm flap) was used to line the oral cavity. Results: The prelamination procedure was relatively easy and useful. The skin graft was well taken to the flap. After 2nd stage operation, the flap survived uneventfully. There was no prolapse of the inset flap into the oral cavity and the cutaneous portion of the flap was mucosalized. The procedure was very successful and the patient can enjoy normal rigid diet and speech. Conclusion: The use of prelaminated radial forearm free flap for hard palate reconstruction is an excellent method to restore oral function. Based upon the result of this case, microvascular free flap transfer with prelaminated procedure is a valid alternative to the prosthetic obturator for palatal defect that provides an improved quality of life. It should be considered as an integral component of head and neck cancer therapy and rehabilitation.