Closure of anterior palatal fistula using tongue flap: our experience

Authors

  • Peerzada Umar Farooq Baba Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Tawheed Ahmad Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Mir Mohsin Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Haroon Rashid Zargar Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Adil Hafeez Wani Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Mohammad Inam Zaroo Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Sheikh Adil Bashir Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Altaf Rasool Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Akram Hussain Bijli Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Ovais Habib Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Muhsin Masood Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Mir Yasir Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India
  • Hilal Ahmad Bhat Department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20163500

Keywords:

Cleft palate, Palatal fistula, Tongue flap

Abstract

Background: Palatal fistula is one of the most common complications following cleft palate repair. It occurs mostly due to tip necrosis of palatal flaps. Small palatal fistulas are usually closed by transposition of adjacent tissues, however these local tissues are not sufficient for the closure of bigger fistulas. The tongue flap serves as a reliable and most easily obtainable local flap for closure of large sized palatal fistulas.

Methods: This is a prospective study conducted from Aug 2006 to July 2015 in the department of Plastic & Reconstructive Surgery, SKIMS, Srinagar, Jammu Kashmir, India. A total of 25 patients with large anterior palatal fistula were treated using anteriorly based tongue flap. Patients were selected on the basis of size of fistula (> 1x1 cm), scarred local palatal tissue or history of fistula recurrence after previous attempts of closure using local palatal tissues.

Results: In present study 25 patients of palatal fistula were treated using tongue flap. Eighty percent patients were in the age group of 3 to 5 years. Male-to-female ratio was 2:3. The largest dimension of treated fistula was 4x3 cm. There was partial dehiscence of flap suture line in two patients while remnant fistula was observed in three patients. None of our patients had flap necrosis.

Conclusions: Tongue flap is an excellent and versatile option for closure of large palatal fistulas with high success rate and least morbidity.

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References

Posnick JC, Getz SB Jr. Surgical closure of end-stage palatal fistulas using anteriorly-based dorsal tongue flaps. J Oral Maxillofac Surg. 1987;45:907-12.

Campbell R. Fistula in the hard palate following cleftpalate surgery. Br J Plast Surg. 1962;15:377.

Guzel MZ, Altintas F. Repair of large, anterior palatalfistulas using thin tongue flaps: long-term follow-up of 10patients. Ann PlastSurg. 2000;45:109-14.

Millard RD. Cleft craft-the evolution of its surgery vol III—alveolar & palatal deformities. Little Brown & Co., Boston. 1980; 809-94.

Visscher SH, van Minnen B, Bos RRM. Closure of oroantral communications: a review of literature. J Oral Maxillofac Surg. 2010;68:1384-91.

Murthy J. Descriptive study of management of palatal fistula in one hundred and ninety-four cleft individuals. Indian J Plast Surg. 2011;44:41-6.

Bénateau H, Traoré H, Gilliot B, Taupin A, Ory L, GuillouJamard MR, et al. Repair of palatal fistulae in cleft patients. Rev Stomatol Chir Maxillofac. 2011;112:139-44.

Kinnebrew MC, Malloy RB. Posteriorly based, lateral lingual flaps for alveolar cleft bone graft coverage. J Oral Maxillofac Surg. 1983;41:555-61.

Al-Qattan MM. A modified technique of using the tongue tip for closure of large anterior palatal fistula. Ann Plast Surg. 2001;47:458-60.

Posnick JC, Getz SB., Jr Surgical closure of end-stage palatal fistulas using anteriorly-based dorsal tongue flaps. J Oral Maxillofac Surg. 1987;45:907-12.

Bütow KW, Duvenage JG. Pedicled “flap” from a tongue flap. Int J Oral Maxillofac Surg. 1986;15:581-4.

Ceran C, Demirseren ME, Sarici M, Durgun M, Tekin F. Tongue flap as a reconstructive option in intraoral defects. J Craniofac Surg. 2013;24:972-4.

Guerrero-Santos J, Garay J, Torres A. Tongue flap with triple fixation in secondary cleft palate surgery. In: Sanvenero-Rosselli G, Boggio-Robutti C (eds) Transactions of the fourth international congress of plastic surgeons. Excerpta Medica Foundation, Amsterdam. 1969;396.

Smith DM, Vecchione L, Jiang S, Ford M, Deleyiannis FW, Haralam MA, et al. The Pittsburgh FistulaClassification System: a standardized scheme for the descriptionof palatal fistulas. Cleft Palate Craniofac J. 2007;44:590-4.

Musgrave RH, Bremner JC. Complications of cleft palate surgery. Plast Reconstr Surg. 1960;26:180.

Edgerton MT, De Vito RV. Reconstruction of major defects of palate. Plast Reconstr Surg. 1956;17:105-29.

Jackson IT. Closure of secondary palatal fistulae with intra-oral tissue and bone grafting. Br J PlastSurg. 1972;25:93-105.

Gordon NC, Brown SL. Closure of oronasoantral defects: report of case. J Oral Surg. 1980;38:600-5.

Piggot RW, Reiger FW, Moodie FA. Tongue flap repair ofcleft palate fistula. Br J PlastSurg. 1984;37:285-93.

Busić N, Bagatin M, Borić V. Tongue flaps in repair of large palataldefects. Int J Oral Maxillofac Surg. 1989;18:291-3.

Assunçao AG. The design of tongue flaps for the closure of palatal fistulas. Plast Reconstr Surg 1993;91:806-10.

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Published

2016-12-19

How to Cite

Farooq Baba, P. U., Ahmad, T., Mohsin, M., Zargar, H. R., Wani, A. H., Zaroo, M. I., Bashir, S. A., Rasool, A., Bijli, A. H., Habib, O., Masood, M., Yasir, M., & Bhat, H. A. (2016). Closure of anterior palatal fistula using tongue flap: our experience. International Journal of Research in Medical Sciences, 4(11), 4705–4708. https://doi.org/10.18203/2320-6012.ijrms20163500

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Original Research Articles