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Meta-Analysis
. 2023 Dec;280(12):5177-5191.
doi: 10.1007/s00405-023-08191-7. Epub 2023 Aug 24.

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

Armando De Virgilio  1   2 , Elisa Bellini  3   4 , Gian Marco Pace  5   6 , Andrea Costantino  1   2 , Bianca Maria Festa  1   2 , Andrea Iandelli  3   4 , Elena Russo  1   2 , Claudio Sampieri  7   8   9 , Giorgio Peretti  3   4 , Giuseppe Spriano  1   2 , Filippo Marchi  3   4
Affiliations
Meta-Analysis

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

Armando De Virgilio et al. Eur Arch Otorhinolaryngol. 2023 Dec.

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.

Keywords: Feeding tube; Flap; Functional outcomes; Head and neck cancer; Soft palate.

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