A team of surgeons from Lviv and the USA executed a groundbreaking procedure to reconstruct a palate by utilizing a radial forearm flap to close a significant defect.
This was the first case of its kind in Ukraine, as reported by the "Okhmatdyt" medical center.
The surgery was performed on an 18-year-old male patient who had previously undergone 11 unsuccessful attempts to correct his palate defect, each worsening his condition.
As he approached adulthood, the young man fell into depression, losing hope for help. He faced difficulties eating, with food entering his nasal cavity, and he struggled with speech, which led to social withdrawal.
"The issue was that after so many surgeries, a large defect in the palate remained that could not be stitched together. An innovative solution was required – the transplantation of his own tissues.
For such tasks, not just any skin can be used; a radial forearm flap is needed. Thus, we decided to apply this unique technique, which had not been used in Ukraine before," the surgeons explain.
Maxillofacial surgeon Roman Ohanovsky clarified that they employed a free tissue transfer technique, also known as the flap technique. This method is typically used for repairing large defects resulting from gunshot wounds or cancer surgeries. Given the patient's similar defect, this technique proved to be the most effective.
Prior to the operation, the patient was consulted by leading American head and neck surgeons. Plastic and reconstructive surgeon David Lowe, who was already aware of the young man's situation, examined the patient and together with the medical team developed a complex intervention plan.
"We analyzed all possible surgical treatment methods for this pathology, and based on David Lowe's recommendation, we chose the free transfer of the radial flap from the forearm. To ensure the best outcome, we employed a comprehensive approach – an orthodontist worked with the patient beforehand, and the tissues were prepared for the surgery," emphasized maxillofacial surgeon Kristina Pohanichna.
The surgeons used the radial forearm flap technique, taking an artery, vein, and skin-subcutaneous flap and transplanting it to the area of the palate defect. The operation lasted 7 hours and was successful.
"The first three days after the surgery were critical. It was crucial to monitor the flap's survival and the functionality of the anastomosis. We observed the pulsation of the vessels on the flap and anastomosis.
This indicates that we succeeded – the tissues are functioning in their new location, the palate receives sufficient blood supply, and the postoperative wound is healing well," noted vascular surgeon Yulia Khomin.
The doctors successfully closed the palate defect. Now the young man can eat normally, and his speech is expected to improve. Additionally, a hospital psychologist is working with him to help combat his depression.
