I had part of the soft palate removed. The surgeon attempted to use a flap from the hard palate (cut part of it to cover hole in soft palate) but decided after cutting that it would not work and put it back on the hard palate.

Does this make sense or should the surgeon know before cutting whether it would fit or work.

I have heard of using a free flap from the forearm or leg to close a soft palate surgical wound, but I haven't heard of using hard palate tissue for the soft palate closure. There is another person who just started posting who has had soft palate surgery as part of his overall treatment. He began posting about a week ago......in either General or Introduce yourself. I have no idea whether or not his attempt to use the hard palate was a good idea. How, then, would he have planned to close the hard palate?

Hi TRT,

I just had the "Free Flap" done on Feb. 13th to replace partial of my soft palate.What they did was take a several layer deep skin graft from the underside of my wrist, including blood supply. They then grafted this to my soft palate area as well as (I think) the back of my esophogus.
They then grafted a layer from my thigh which they used to graft on my inside wrist from which they got the original graft.

So far can swallow pretty well, speech sounds about the same. He did nick the nerve to my tongue, so right now my speec is a little slurred, but will go away.

Hope this helps. If I can be of further assistance, please let me know.

Jon

Maybe I did not fully understand. I'll have to ask. There was a graft taken from the thigh but I think that was used for the cheek area and mostly fell off.

Even though the tumor was on the soft palate. The whole length of the hard palate was cut and the gum is exposing the tooth on one side.
The surgeon is well known and the residents were impressed by the stitching etc.
I did have a 'difficult' recovery with bleeding from the hard palate however.

An obturator was recommended but eventually scarred tissue filled in as it took me a long time to prepare for radiation.

The part that I don't get is that the surgeon has to try and see if it fits.

Interesting...When did you have your surgery? You have had a lot of healing time. Do I understand that you have had radiation already too? or are you about to begin that?

Surgery 3 months ago. Just starting rad now.

I had a free flap elevation from both my lower leg and my wrist. The tissue from my leg was removed, and they rejected it for implantation because they couldn't get it to perfuse properly.

They then went with the flap from my wrist to rebuild the lining of my mouth. The opening in my wrist was covered over with a skin graft from my thigh as well. You mentioned that the graft to your cheek fell off for the most part; I believe that is pretty normal...the grafted tissue (at least the uppermost layers) sluffs off a few weeks after grafting.

By that time, the tissue growth is well underway, so it's well on the way to healing.

I think the surgeons have to have a plan "A", a backup plan "B", and maybe even a plan "C".

It really makes a lot of sense. If the ideal outcome isn't possible (as in my case) there has to be an alternative to doing nothing.

Even though they had done an angio-CT of the leg they were going to use for donor tissue, they still couldn't know for certain if the blood supply was adequate until surgery had begun.

I guess I choose to look at it a bit differently; Perhaps the flap from the hard palate would have been less invasive overall if it had worked. It would be something that you have every right to ask the Doctor about, though. You're entitled to know after all
Wayne

Hard palate flap....May I presume that this flap was only the skin of the palate, and not the bone? What would he have used to cover the denuded area of the hard palate, I wonder?

I think it was skin only.

I wish they told me that the scar tissue would fill in everything. This happened in about a month as it was small.
That is much better than obturators or flaps, for me. The only thing is that Rad would start a little later.