Single layer closure of palatal fistula using anteriorly based dorsal tongue flap

Babu, H. S. Charan; Bhagvandas, A; Nair, Manju Ananthakrishnan; Meenakshi, .

doi:10.1007/s12663-009-0049-0

Cited by 11 publications

(4 citation statements)

References 10 publications

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“… 10 Dorsal tongue flaps that have been recommended for large palatal perforation closure can be anteriorly or posteriorly based, although the anteriorly based is more recommended. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

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

Rahpeyma

Khajehahmadi

2015

Plastic and Reconstructive Surgery Global Open

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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.

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Section: Discussionmentioning

confidence: 99%

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

Rahpeyma

Khajehahmadi

2015

Plastic and Reconstructive Surgery Global Open

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“…[ 2 ] Tongue flaps are appropriate techniques in such situations. [ 3 ] The replaced tissue is mucosa therefore, it is an ideal reconstruction: “Replacement of the lost tissue with the similar tissue.” Tongue flaps have many variants, including anteriorly, or posteriorly based flaps with axial or random pattern blood supply from dorsal, ventral or lateral portion of the tongue. [ 4 5 6 7 ] Tongue flaps can be used in the reconstruction of the oral cavity in cleft surgery, congenital deformities, and intraoral reconstructions after pathologic resections or traumatic avulsions.…”

Section: Introductionmentioning

confidence: 99%

Posteriorly based lateral tongue flap for reconstruction of large palatal-alveolar fistulas in cleft patients

Rahpeyma¹,

Khajehahmadi²

2015

Ann Maxillofac Surg

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Background:Large palatal fistula in cleft patients is a difficult situation, especially with previous multiple surgeries, which have led to severe scars in the palatal mucosa. Tongue flaps are useful aids in such situations.Materials and Methods:Seven cleft patients who were reconstructed by posteriorly based lateral tongue flap between 2005 and 2012 were studied. Variables such as flap-ability to close the fistula, remaining tongue shape at least 1 year after operation, and speech improvement (patients’ self-assessment) were evaluated.Results:Age range of the patients was 14‒45 years. The male-to-female ratio was 2/7. Posteriorly based lateral tongue flap effectively closed the large fistula in 6/7 of patients. The largest dimensions of fistula closed by this flap was 5 cm × 1.5 cm. Follow-up of 2‒7 years showed that the tongue never returned to the original size and remained asymmetrical. In addition, the nasal speech did not improve dramatically after the closure of large palatal/alveolar fistulas in this age group.Conclusion:Posteriorly based lateral tongue flap is an effective method to solve the problem of large palatal fistulas in adult cleft patients. The most useful indication for this flap is a large longitudinal palatal fistula, extending to the alveolar process. Asymmetrical tongue shape after surgery is the rule and speech improvement depends on patient's age and location of fistula.

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“…5 Tongue flaps were first introduced by Eiselberg for the treatment of intraoral defects, Lexer described their use for the retromolar defects in 1909 and in 1966 Guerrero Santos and Altamirano described the anterior-based tongue flap for the closure of wide palatal fistulas, which is based on the branches of the dorsal lingual artery of the anterior portion of the tongue. 6 However, other authors such as Papioannou and Farr have designed posterior-based tongue flaps for the reconstruction of the cheeks and floor of the mouth. At the time of this writing, the anterior-based tongue flap is considered to reduce the risk of complications and is much more versatile.…”

mentioning

confidence: 99%

“…Some of the available techniques area: palatal flaps, nasal flaps, oral mucosal flaps, facial artery musculomucosal flaps (FAMM), buccinator flaps, tongue flaps, allografts (acellular dermal matrices), and free flaps 5 . Tongue flaps were first introduced by Eiselberg for the treatment of intraoral defects, Lexer described their use for the retromolar defects in 1909 and in 1966 Guerrero Santos and Altamirano described the anterior-based tongue flap for the closure of wide palatal fistulas, which is based on the branches of the dorsal lingual artery of the anterior portion of the tongue 6 . However, other authors such as Papioannou and Farr have designed posterior-based tongue flaps for the reconstruction of the cheeks and floor of the mouth.…”

mentioning

confidence: 99%

Tongue Flap for Closure of Complex Oronasal Fistula

Meneses Argalle,

Espinosa Orozco,

Prada Madrid

2023

Journal of Craniofacial Surgery

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Complex oronasal fistula is one of the most frequent secondary complications of cleft palate correction and is considered a reconstructive challenge. Tongue flaps are one of the procedures for the treatment of complex fistulas associated or not with multiple previous procedures, offering a high success rate, few complications, and problems during its development. This study evaluates the efficacy in terms of functionality, esthetic, donor area morbidity and clarifies surgical technique steps. Descriptive cohort study was performed between August 2011 to August 2021 where an anteriorly based dorsal tongue flap was performed in 30 patients with complex palatal fistulas, evaluating outcomes in terms of technique reproducibility and flap viability, correction of oronasal regurgitation, speech, donor site morbidity, complications, and esthetics. The senior author has used this technique with consistent clinical outcomes to improve complex oronasal fistula with minimal complications, with a good success rate in terms of correction of the palatal defect with imperceptible alteration of the lingual donor area. In addition, establishes a specific definition of persistence and recurrence of oronasal fistula. The tongue flap is considered the gold standard in complex oronasal fistula reconstructions with satisfactory outcomes, and it offers an adequate amount of vascularized tissue achieving fistula closure without functional or esthetic impairment of the donor area and is a highly reproducible technique.

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Single layer closure of palatal fistula using anteriorly based dorsal tongue flap

Cited by 11 publications

References 10 publications

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

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

Posteriorly based lateral tongue flap for reconstruction of large palatal-alveolar fistulas in cleft patients

Tongue Flap for Closure of Complex Oronasal Fistula

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