Abstract
Closure of residual palatal fistulae and oronasal communications from various etiologies, using the resilient and versatile dorsal pedicled tongue flap
Highlights
Oro nasal communications are often encountered following trauma, ablative resection for tumors, Gunshot injuries and most commonly, after previous attempts at closure of palatal and /or alveolar clefts.Reconstruction of intraoral defects is of great importance in order to preserve the unique anatomy and functions of the oral cavity like mastication, taste, swallowing, control and disposal of saliva, and phonation [1]
The tongue flap at the recipient site remained healthy with no recurrence of the fistula in any of the patients in the two years follow up period
The anteriorly based dorsal tongue flap was introduced by GuerreroSantos and Altamirano in 1966 for the surgical closure of a large palatal fistula [6]
Summary
Oro nasal communications are often encountered following trauma, ablative resection for tumors, Gunshot injuries and most commonly, after previous attempts at closure of palatal and /or alveolar clefts. Because of the inadequacy of tissue around anterior palatal fistulas, local mucoperiosteal flaps are of limited value in their closure In such cases, tongue flaps have been found extremely useful in intraoral defect reconstruction [5]. Following the wide local excision that was carried out, he developed a persistent oronasal communication (Figures 8F-H) In all these three patients, feasibility of local palatal mucoperiosteal flaps for reconstruction of the defect was ruled out owing to the traumatized, scarred, fibrosed and inadequate quality of the palatal tissues. The tongue flap at the recipient site remained healthy with no recurrence of the fistula in any of the patients in the two years follow up period Their phonation improved dramatically and there was a complete resolution of the problem of nasal regurgitation of orally ingested fluids and food particles. There was observed no deformity or articulation defect resulting from the flap harvested from the tongue dorsum, in any of the patients (Figures 4G,7F,10H)
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