Authors : Ulfah Hermin Safitri*, Pingky Krisna Arindra**đź–‚, Bramasto Purbo Sejati**
The occurrence of a palatal fistula following cleft palate surgery is a common complication, particularly in patients with palatal clefts. The reconstruction of these defects often leads to the formation of palatal fistulas, which may develop due to the ratio of cleft width to the surrounding available palatal tissue for reconstruction. Additionally, palatal fistulas post-palatoplasty can occur from hematoma formation at the surgical site, that can cause a communication between the oral and nasal cavities. This occurs due to poor tissue approximation and potential tissue necrosis caused by trapped blood. Tongue flaps are considered the preferred method for closing anterior palatal fistulas, as they offer the advantages of excellent vascularity, mobility, and versatility in positioning. This study aims to evaluate the effectiveness of the tongue flap technique in repairing anterior palatal fistulas. This case report presents a 29-year-old female patient with large anterior palatal fistulas that had failed to close previously (sequelae). The patient also presented with inadequate local scars, oronasal communication, fluid regurgitation, and hypernasal resonance. To address these issues, a pedicle tongue flap was used to close the oronasal fistula. The procedure involved creating a flap from the tongue, which was sutured to the palatal defect. The healing process was uneventful, and the pedicle flap division was done and closed primarily. There was reported no nasal regurgitation, no wound dehiscence, the patient’s masticatory function was preserved, and good speech intelligibility. Pedicle tongue flaps are an effective for closing palatal fistulas and are the preferred technique for repairing oronasal fistulas after palatoplasty revisions.