Anterior Palatal Fistula Closure with Tongue Flap

Abstract

Palatal fistula is an abnormal oronasal communication with incidence of 4% to 35% and recurrence up to 25%. Repairing large palatal fistula can be technically challenging. Anteriorly based tongue flap may be the flap of choice for recurrent and symptomatic anterior palatal fistula. A case of bilateral complete cleft lip, alveolus and palate with residual anterior palatal fistula was successfully managed with anteriorly based tongue flap. Postoperative care included liquid diet, oral hygiene and flap division after 2 weeks. Wound healing was satisfactory and uneventful. No flap loss, speech impairment, taste disturbance or functional tongue morbidity was noted. The tongue flap is a highly reliable flap with reported success rates of 85% to 95.5% in management of palatal fistula. Based on our experience, tongue can be considered a good option and highly recommended for the closure of large & recurrent palatal fistula.