Nasoseptal flap for reconstruction after robotic radical tonsillectomy

Abstract

BACKGROUND: The nasoseptal flap has revolutionized reconstruction of ventral skull base defects. The past decade is also noticeable by the evolution of transoral robotic surgery (TORS). Reconstruction of the oropharyngeal defect is challenging. Good reconstructive options with less cicatricial retraction are desirable and still lacking in the literature. METHODS: Cadaver dissection and illustrative case are used to show the feasibility of harvesting a nasoseptal flap to reconstruct oropharyngeal defect after radical tonsillectomy. Surgical resection included part of the soft palate and tongue base. RESULTS: The flap was sufficient to cover two-thirds of the tonsillar defect during the cadaver dissection. In our illustrative case, the flap filled the palatal defect and also was sufficient to cover the superior half of the tonsillar defect. CONCLUSION: The nasoseptal flap has shown to be feasible and reliable for reconstruction of the oropharyngeal defect after TORS. When soft palate resection is warranted, this flap provides excellent coverage. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2495-E2498, 2016.