Double palatal flap for oro-nasal fistula closure - 23/03/18

Doi : 10.1016/j.jormas.2017.11.008

P. Pouzoulet ^a,^d,^e, N. Graillon ^a,^d,^e, L. Guyot ^a,^d,^e, C. Chossegros ^b,^e, J.M. Foletti ^c,^d,^⁎
^a Aix-Marseille université, 13916 Marseille, France
^b CNRS, LPL UMR 7309, Aix-Marseille université, 13100 Aix-en-Provence, France
^c IFSTTAR, LBA UMR_T 24, Aix-Marseille université, faculté de médecine campus nord, chemin des Bourrely, 13916 Marseille, France
^d Service de chirurgie maxillo-faciale, hôpital Nord, AP–HM, 13915 Marseille cedex 20, France
^e Service de chirurgie maxillo-faciale, hôpital de la Conception, AP–HM, 13005 Marseille, France

^⁎Corresponding author. IFSTTAR, LBA UMR_T 24, Aix-Marseille université, 13916 Marseille, France.

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Abstract

Introduction

The management of oral fistula to the nose depends on its etiology, its size and its location. Here, we describe a simple technique, inspired by the ones initially developed by Bardach for cleft palates repair. The surgical alternatives are discussed.

Technical note

The double palatal flap is a simple technique, allowing closure in a single session of a central or centro-lateral palate fistula. The key of this technique is the dissection between nasal and palate mucous layers, providing a sufficient amount of laxity to close the defect without tension.

Discussion

The double palatal flap can cover centro-lateral palate mucosal fistulae. It provides both aesthetic and functional results in a single stage. Reliability, simplicity and quickness are its main advantages. Outcomes are usually simple; Velar insufficiency may occur, that can be corrected by speech therapy.

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Keywords : Palate, Oral fistula, Surgical flaps