Successfully Closing an Acquired Palatal-fistula Using a Turnover Flap from a Previously Transferred Forearm-free-flap

Abstract

Summary:Palatal fistula between the oral and nasal cavities occurs in about 20% of palatal repairs after oncologic resection. Although healing by secondary intention may be employed as an initial strategy, persistent nonhealing symptomatic fistula necessitates intervention. Folded free flap used for primary repair of palatectomy defects enables placement of epithelialized tissue on both the oral and nasal cavities. In case of acquired palatal fistula, a turnover flap can be easily created, based on the free margin of the folded forearm free flap to serve as a reconstructive lifeboat.

Free Flap Reconstruction of Recalcitrant Defects in Cleft Palate Patients

“…An intact palate is very important to avoid hypernasality, speech difficulty, leakage to nasal region during nutrition, and swallowing difficulties 7,8. However, the fistula may occur even in experienced hands due to some reasons such as preoperative physical conditions of the cleft.…”

“…An intact palate is very important to avoid hypernasality, speech difficulty, leakage to nasal region during nutrition, and swallowing difficulties. 7,8 However, the fistula may occur even in experienced hands due to some reasons such as preoperative physical conditions of the cleft. No matter how, once a fistula occurs after treatment, it can be difficult to close and the rate of recurrence is up to 33% in the literature.…”