Repair of a chronic oronasal defect with an anteriorly based tongue flap: Report of a case

Zeidman, Andrew; Lockshin, Arnie; Berger, Julius; Gold, Burton M.

doi:10.1016/0278-2391(88)90228-5

Cited by 19 publications

(14 citation statements)

References 12 publications

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“…7 In accordance with literature, most of the fistulas were located in anterior palate. 8 In our study, The Pittsburgh Fistula Classification System was used to describe fistula. 5 Most of the fistulas were seen at the junction of the primary and secondary palate (type V).…”

Section: Discussionmentioning

confidence: 99%

The Versatility of the Tongue Flap in the Closure of Palatal Fistula

Vasishta

Krishnan

Rai

et al. 2012

Craniomaxillofacial Trauma & Reconstruction

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Aims Tongue flaps were introduced for intraoral reconstruction by Lexer in 1909. A retrospective study was performed in the Department of Oral and Maxillofacial Surgery, S.D.M. College of Dental Sciences (Dharwad, India), to assess the use of tongue flap in closure of palatal fistula. Material and Methods A total of 40 patients treated for palatal fistulas were included in this study from the period of January 1, 2000, to January 1, 2007; fistulas present in anterior and midpalate were considered. Patients' preoperative photographs, clinical records, and preoperative speech analysis were recorded. Following completion of fistula closure, patients were assessed over 6 months to check flap viability, fistula closure, residual tongue function, aesthetics, and speech impediment. Results A total of 40 (24 male and 16 female) patients with palatal fistulas were treated with tongue flap in our study. Six patients were 4 to 6 years old, three were 7 to 10 years old, and 22 were 11 to 20 years old, which accounts for 68% of study subjects. There were nine patients 21 to 30 years old. In the early postoperative period, we encountered bleeding in one patient and sloughing in one patient. There are three recurrences, and two flaps were detached; all remaining cases showed satisfactory healing, and donor site morbidity was minimal. No speech deficits were evident. Conclusion Tongue flaps are used in cleft palate surgery because of their excellent vascularity, and the large amount of tissue that they provide has made tongue flaps particularly appropriate for the repair of large fistulas in palates scarred by previous surgery.

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Section: Discussionmentioning

confidence: 99%

The Versatility of the Tongue Flap in the Closure of Palatal Fistula

Vasishta

Krishnan

Rai

et al. 2012

Craniomaxillofacial Trauma & Reconstruction

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“…The width of the flap should be equal to the width of the defect plus about 20%. The flap should be thick enough to include several millimeters of muscle to protect the submucosal vascular plexus [2,3,[5][6][7]10,11]. The surgeon must not hesitate to raise a large flap (5-6 cm long, 1 cm thick) to ensure its vascular viability and allow considerable tongue movement without undue tension on the pedicle [4,7].…”

Section: Discussionmentioning

confidence: 99%

“…Detailed history revealed about six surgeries for the correction of cleft lip and palate. A systematic local examination revealed the presence of a large hole type [3] of oronasal fistula which was roughly triangular in shape and each side measuring about 3cms crossing alveolus between left central and lateral incisors (Fig. 1).…”

Section: Case Reportmentioning

confidence: 99%

“…Depending on the site of fistula, it may be posteriorly or anteriorly based [1,2]. The tongue flap is indicated for closure of a large persistent palatal fistula, in heavily scarred palates and in cases with previous attempts have been unsuccessful [3]. The tongue flap offers the advantages of an abundance of tissue for palatal reconstruction, an excellent blood supply and ease of rotation1.…”

Section: Introductionmentioning

confidence: 99%

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

Babu

Bhagvandas

Nair

et al. 2009

J. Maxillofac. Oral Surg.

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Palatal fistulas are the common complications seen after cleft palate repair. Small fistula may be asymptomatic, the large ones produce various symptoms including regurgitation of fluids into nasal cavity and interference with normal speech. Although small fistulas can be successfully treated with local flaps such as palatal or buccal mucosal flaps, large fistulas pose difficulty. Because of rich blood supply, tongue is a suitable and convenient source of large flap. The anterior based dorsal tongue flap is a safe and effective method for closure of relatively large recurrent palatal fistula with out any functional impairment of donor site. This article describes one such case treated by single layer closure using anteriorly based tongue flap with excellent outcome.Keywords Palatal fistula · Cleft palate · Local flaps · Rich blood supply of tongue · Anterioly based dorsal tongue flap

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“…Its central position, mobility, and excel-lent blood supply permit a great variation in the location of the defects t o repair: lip^,^-^,^-' palate,6. [10][11][12][13][14][15][16][17][18][19][20] floor of the m~~t h ,~,~~.~~ cheek muc o s a , '~~~ ~r o p h a r y n x ,~~ and h y p~p h a r y n x .~~ The anatomical basis for tongue-flap design was presented by Bracka,26 who clearly described the distribution of the lingual vascular tree. Blood is supplied to the tongue by a pair of lingual arteries, which course from the tongue base along the ventral surface of the tongue, deep in the main muscle mass.…”

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confidence: 99%