Closure of Huge Palatal Fistula in an Adult Patient with Isolated Cleft Palate

Abstract

Summary:Closure of huge palatal fistula surrounded by fully erupted permanent dentition in the adult patients with cleft is a challenge. Posteriorly based buccinator myomucosal flap is a neurovascular pedicled flap, with inherent nature of thin thickness, saliva secretion, and axial pattern blood supply. Vicinity of donor site to the palate and low donor-site morbidity are the other advantages. It is an ideal choice in such situation. In this article, the details of surgical technique and the effectiveness of this method are presented.

Use of a buccinator myomucosal flap and bilateral pedicled buccal fat pad transfer in wide palatal fistula repair: a case report

“…Operations 1 and 2 focused on repairing the fistula (defect repair), while operations 3 and 4 focused on correcting the VPI. Using a pedicle-based buccinator myomucosal flap has the advantage of replacing the lost tissue with the same type of tissue [ 8 , 14 ]. The myomucosal buccinator flap, first described by Bozola in 1989, has become an essential tool for intraoral defect reconstruction.…”

“…The myomucosal buccinator flap, first described by Bozola in 1989, has become an essential tool for intraoral defect reconstruction. Various forms of myomucosal cheek flaps have been proposed in the literature, both pedicled and island, based on the buccal or the facial arteries [ 14 ]. Cases of myomucosal flaps used for tongue reconstruction have also been reported [ 13 , 14 ].…”

“…Various forms of myomucosal cheek flaps have been proposed in the literature, both pedicled and island, based on the buccal or the facial arteries [ 14 ]. Cases of myomucosal flaps used for tongue reconstruction have also been reported [ 13 , 14 ]. Furthermore, the use of pharyngoplasty for VPI correction is associated with favorable speech outcomes [ 15 ].…”

Maxillary artery based flaps for oral cavity reconstruction, a review

“…Posteriorly based buccinator myomucosal flap was first introduced in 1989 by Bozola [8] . Pivotal point is near the pterygomandibular raphe and mainly is used for post palatoplasty oronasal fistula closure or correction of velopharyngeal insufficiency in cleft patients [9] , [10] . This flap could pass to palate through edentulous gap or by the aid of bite block in closed arch mouth [11] .…”

Lateral Soft Palate Growth Deficiency: Case Report and Therapeutic Management

“…The former involves significant risks, and the resulting soft palate function is often relatively poor. Disadvantages of the latter include discomfort (Rahpeyma and Khajehahmadi, 2015).…”