Functional outcomes of soft palate reconstruction after oncologic surgery: a systematic review and meta-analysis.

Giorgio Peretti, Filippo Marchi, Armando De Virgilio, Elisa Bellini, Gian Marco Pace, Andrea Costantino, Bianca Maria Festa, Andrea Iandelli, Elena Russo, Claudio Sampieri, Giuseppe Spriano

Journal: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2023;280(12):5177-5191

PMID: 37620732

Abstract

OBJECTIVE

The aim of this study is to analyze functional outcomes of soft palate reconstruction after oncologic surgery.

METHODS

This study was conducted in conformity with the PRISMA statement. A single arm meta-analysis was performed for feeding tube dependence (FTD) (primary outcome), velopharyngeal insufficiency (VPI) and hypernasality (HN) (secondary outcomes) incidences.

RESULTS

A total of 510 patients (males: 77.75%, n = 353/454) with a median age of 58 years (n = 480/510; 95% CI 57.0-61.0) who underwent soft palate surgical resection with primary reconstruction were included. Overall, the cumulative FTD rate was 1.55% (n = 28/510; 95% CI 0.24-3.96%), the VPI rate was 22.18% (n = 119/379; 95% CI 12.99-33.02%), and the HN rate was 33.01% (n = 88/234; 95% CI 19.03-46.61%).

CONCLUSIONS

Soft palate reconstruction results in a low incidence of FTD, and most patients resume a full oral diet. Both obturators, primary closure, local and free flaps seem good reconstructive options. Nevertheless, more specific postoperative functional deficiencies like VPI and HN owns higher incidences, potentially affecting the quality of the swallowing and speaking function and the patient's quality of life.

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Address: Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy.; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy.; Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy. [email protected].; Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy. [email protected].; Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy.; Functional Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain.; Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain.

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