Closure of Anterior Palatal Fistula by Tongue Flap: A Prospective Study

Abstract

The results obtained during the course of this study strongly support the method used to close the anterior palatal fistula. It is concluded that the dorsal tongue flap is the highly successful method without the need of additional fixation devices in closure of anterior palatal fistula.

Double Tongue Flaps for Anterior Huge Palatal Fistula Closure

“…In 1966, Jose Guerrero-Santos suggested the use of tongue flap to repair hard palate fistulas introduced by complications from cleft palate surgery, where 3 cases out of 10 were illustrated. 7 Since then, many studies had been reported where the authors generally discussed the indications, procedures, tongue flap fixation, management of the complications, flap blood supply, and pedicle position. 9,10,13–25 Despite the fact that tongue flap has been proven to be a sturdy, reliable, and efficient means for the closure of hard palate fistula especially in the anterior region, there existed unsuccessful cases due to the over mobility of tongue, and sometimes the massive size of fistula.…”

“…It has been well accepted that tongue flap is one of the methods that is mostly utilized to repair palate fistula, although several other operation procedures have also been used. 4–6 Firstly introduced by Guerrero-Santos J and Altamirano JT in 1966, 7 the protocol of the tongue flap has been described extensively in the literature. 8–10 Nevertheless, there is no study demonstrating the application of double tongue flaps method in palate fistula repairing surgery as of today.…”

Oronasal fistula as a cleft palate sequela : closure with tongue flap. Case report with review of the literature

“…Studies of the tongue flaps have been conducted in a few special situations: -wide fistulae (>1 cm) [3,6,10,[15][16][17]; -anterior fistulae [6,10,15,18,19]; -residual fistulae on scars from multiple surgical interventions [5,15]. These three criteria are different in children and adults, studies on the closure of oral fistulae using tongue flaps all report a high success rate of 85-100% with reliability and reproducibility [6,10,13,[15][16][17]20].…”

“…Studies that have studied the result on phonation report 75% success rates in decreasing hypernasal speech [6,13,19]. The closure of an oral fistula by tongue flap remains effective if a transverse palatal expansion is performed, as shown in the series by Guzel and Altintas, with a 90% absence of recurrence [10].…”

Treatment of Oral Fistulas

“…To lower flap mobility, fixing the tip of tongue to the upper lip or anterior maxillary incisors may be done. Also prefabricated flap retainers or intermaxillary fixation can be used for this aim [29]. After 3 weeks, with a second operation, the pedicle should be divided and the contouring should be done.…”