Dr. N. Chandramouli Hariharan., Dr. M. Sugumar


INTRODUCTION: The incidence of post palatoplasty palatal fistula has been reported to range from 8.7% to 23%. Due to multiple attempts at
fistula closure the palatal tissue surrounding the fistula is scarred. Any further attempt to close the fistula using the local flap of scar based on the
scarred pedicle is destined to be a failure. Hence we formulated a protocol of using the tongue flap to ensure successful outcome.
PATIENTS AND METHODS:This is a prospective study Cases of palatal fistula that were referred to our centre from January 2012 to December
2017.Patients who underwent more than two procedures and with a persistent fistula of more than 5 mm in size were classified as cleft palate cripple
and included in the study. During this period we operated 15 cases of cleft palate cripple. The size of the fistula ranged from 5 mmm to 5
cm.Tongue flap was done in all the cases.There was no case of flap dehiscence or flap necrosis.
CONCLUSION:Though the management of recurrent palatal fistula is a surgical challenge, closure of the fistula using distant vascularised tissues
as tongue flap offers a predictable solution.


Palatal fistula; cleft palate cripple; tongue flap.

Full Text:



Cohen SR 1 , Kalinowski J , LaRossa D , Randall P . Cleft palate fistulas: a multivariate statistical analysis of prevalence, etiology, and surgical management. Plastic and Reconstructive Surgery 01 Jun 1991, 87(6):1041-1047.

Muzaffar AR 1 , Byrd HS , Rohrich RJ , Johns DF , LeBlanc D , Beran SJ , Anderson C , Papaioannou a A . Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.Plastic and Reconstructive Surgery 01 Nov 2001, 108(6):1515-1518.

Emory RE Jr 1 , Clay RP , Bite U , Jackson IT. Fistula formation and repair after palatal closure: an institutional perspective.Plastic and Reconstructive Surgery 01 May 1997, 99(6):1535-1538.

S. L. A. Jeffery, J. G. Boorman and D. C. Dive. Use of cartilage grafts for closure of cleft palate fistulae.British Journal of Plastic Surgery (2000), 53, 551-554 .

Schultz RC Management and timing of cleft palate fistula repair. Plastic and Reconstructive Surgery 01 Dec 1986, 78(6):739-747.

R. Naddaf,O. EmodiJ. GeorgeA. Rachmiel Cleft palate fistula closure utilising acellular dermal matrixInternational journal of oral and maxillofacial surgery March 2017Volume 46, Supplement 1, Page 66.

Rahpeyma, Amin , Khajehahmadi, Saeedeh . Closure of Huge Palatal Fistula in an Adult Patient with Isolated Cleft Palate: A Technical Note.Plastic and Reconstructive Surgery – Global Open: February 2015 - Volume 3 - Issue 2 - p e306

doi: 10.1097/GOX.0000000000000279

R.W. Pigott, F.W. Rieger, A. Frazer Moodie.Tongue flap repair of cleft palate fistulae

JPRAS ,July 1984 Volume 37, Issue 3, Pages 285–293

Jyotsna Murthy. Descriptive study of management of palatal fistula in one hundred and ninety-four cleft individuals . Indian J Plast Surg. 2011 Jan-Apr; 44(1): 41–46.

Coghlan K , O'Regan B , Carter J .Tongue flap repair of oro-nasal fistulae in cleft palate patients. A review of 20 patients. Journal of Cranio-maxillo-facial Surgery 01 Aug 1989, 17(6):255-259.


  • There are currently no refbacks.