Evaluation of postoperative function in patients undergoing reconstruction following resection of superior and lateral oropharyngeal cancer: long-term outcomes of reconstruction with the Gehanno method

Classification of the extent of defects in the oropharynx (draught).

Procedure for reconstruction. (1) Resection of the lateral wall and superior wall (including a part of the lingual root) of the oropharynx. (2) Freeing of the pharyngeal myomucosal flap from the oropharyngeal posterior wall stump (*), followed by superomedial eversion. (3) Suturing of the pharyngeal myomucosal flap to the soft palate and hard palate stump in sequences, followed by suturing of the lingual root to the pharyngeal posterior wall stump. (4) Covering of the exposed mucosal defect with the free flap.

Results for speech clarity.

Results for monosyllabic word clarity (a) 100 words for the oropharynx test; (b) 16 velar consonants.

Results for blowing ratio.

Case 3: 57 months after surgery (reconstruction with the rectus abdominis myocutaneous flap). (a) The flap remains bulky and the pharyngeal cavity formed is narrow. (b) Complete closure of the nasopharyngeal cavity was achieved during swallowing. (c) Newly formed velopharyngeal port. (d) VF revealed no sign of nasopharyngeal regurgitation and mis-swallowing.

Case 2: 58 months after surgery (reconstruction with the forearm flap). (a) Atrophy of the resected area caused extensive upward spread of the pharyngeal cavity. (b) Closure of nasopharyngeal cavity is slightly incomplete during swallowing. (c) VF revealed no sign of nasopharyngeal regurgitation and mis-swallowing.