Reconstrucción de fístula palatina anterior con colgajo lingual de base anterior. Reporte de un caso

Reconstruction of Oronasal Fistula with Tongue Flap: A Cleft Palate Report

“…In the reported case, the patient presented a CLP, skeletal Class II agenesis of the upper laterals and oronasal fistula persistence. Due to failure of three previous local mucosa flap surgeries, the oronasal fistula had significant scar tissue around the edges [ 7 , 18 ]. Additionally, the patient’s maxillary arch was collapsed and V-shaped, which could have been the result of several maxillary surgeries.…”

“…However, in this case, it was not chosen since it requires several surgical reinterventions. Previous studies reported that when large fistula are present (wider than 10 mm), a pedicle tongue flap is the most successful surgical option for treatment of oronasal communication [ 9 , 18 ]. Moreover, in cases with excessive scarring or in which the cleft palate could be closed though previous palatal or vestibular flap surgeries, a tongue flap procedure can be the solution for a persisting oronasal fistulae [ 18 , 30 ].…”

“…There are two types of pedicle tongue flaps: anteriorly and posteriorly based. The posterior-based flaps are recommended in cases of soft palate, posterior mucosa, and retromolar area defects, while anterior-based flaps are indicated in cases of hard palate, anterior floor, oral mucosa, mouth, and lip defects [ 18 ]. Taking these indications into account, this patient was subjected to an anterior-based flap.…”

“…Taking these indications into account, this patient was subjected to an anterior-based flap. To avoid tension during the healing process, the length and width of the tongue flap was 20% greater than the communication and had between five and seven millimeters of thickness in order to avoid any injuries to the vascular plexus [ 18 , 31 ]. After the tongue flap separation surgery, several controls were performed to assess healing.…”

Rotación de colgajo lingual para el cierre de fistulas palatinas. Revisión bibliográfica

“…No obstante, no fue sino hasta 1966 que Guerrero Santos reporta el uso de colgajos linguales con la finalidad de conseguir un cierre hermético de las fístulas palatinas. 1,2 Estas fisuras se consideran una malformación congénita, su origen es embrionario y se desarrolla como tal entre la tercera y décima semana de vida intrauterina, los factores hereditarios y ambientales son destacables en el desarrollo de esta malformación. Adicionalmente, la deshisdencia de una palatoplastía primaria puede ser causada por varios factores.…”