Repair of Oronasal Fistula With Split-Skin Graft on Nasal Side and Mucosal Flap on Oral Side

Abstract

We repaired a case with a huge oronasal fistula using split thickness skin graft (STSG) on nasal side and mucosal flap on oral side. A 21-year-old man presented an oronasal fistula of the hard palate, measuring 2.0 x 1.2 cm. The fistula was 2 cm posterior to the incisive foramen. The scar tissue around the fistula was unhealthy. The defective nasal side was floored with a skin graft 1.5 cm x 2.0 cm in size and 12/1000 in thickness. The skin graft was sutured around to the fistula edge with 4-0 chromic suture. Donor site was a lateral aspect of the thigh. A laterally based oral mucosal flap, 2.5 x 2 cm, was designed, raised, and transposed to the defect. The secondary defect was covered with buccal mucosal graft. The oral mucosal flap was viable, the skin graft took, and no sign of recurrence of fistula was noted until one month postoperative. This method can be an alternative in repair of the oronasal defect when any local tissue for repair is not available or sufficient.