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| |  New Reconstruction Technique Makes Speaking, Eating Possible After Tonsil Cancer Surgery ANN ARBOR, Mich -- September 21, 2009 -- A new technique for reconstructing the palate after surgery for tonsil cancer maintained patients’ ability to speak clearly and eat most foods, according to a study published in the September issue of Archives of Otolaryngology-Head & Neck Surgery. “This is the area that triggers swallowing, that separates the mouth from the nasal cavity. It affects speech and eating -- typically, patients have difficulty eating when they have this kind of tumour and undergo surgery. We can remove the cancer, but there are major quality of life issues,” says study author Douglas Chepeha, MD, Otolaryngology Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan. Traditional reconstruction efforts have meant taking a large, round piece of tissue to plug the hole left when the tumour is removed. But this impairs the way the palate and tongue function, and does not restore the complex components of the throat that allow a person to speak and swallow. With the new technique, surgeons first create a tube from the remaining palate by attaching the palate to the back part of the throat, next to where the tumour was removed. This tube separates the mouth from the nasal cavity and closes during swallowing, allowing patients to eat and speak. Then the surgeons sew up the defect in the base of the tongue to separate the tongue from the rest of the reconstruction. This ensures that the tongue can move, which improves swallowing and speech. The shape of the remaining defect is irregular, so a template is designed for using transplanted tissue to fill in any other holes left by the surgery. The tissue used in the reconstruction is a transplant from the arm or another part of the patient’s own body. L-shaped patterns, similar to dress patterns, help the surgeon determine the size and shape of the skin tissue they’ll remove for transplant. The study followed 25 patients with tonsil cancer. Patients were grouped based on how much of their palate was removed during surgery: less than half or more than half. The patients were followed for an average of 5 years after the surgery. Both groups reported few problems with speech. Patients who had more than half their palate removed were more limited in what they could eat and reported some restrictions to eating out in public. Emotional scores were high for both groups, suggesting overall satisfaction with their lives. “In particular, patients who have less than half their palate removed do very well with this reconstruction. We’re trying to make sure the remaining tongue and palate they have really work. Our goal is to get patients eating in public and back to work,” said Dr. Chepeha. SOURCE: University of Michigan Health System
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