Closure of fistula of the hard palate with two layers of mucoperiosteum. (January 2018)

• Record Type: Journal Article
• Authors: Abdel-Aziz, Mosaad; Kamel, Ahmed; Fawaz, Mohamed; Rezk, Ibrahim; Kamel, Mohamed
• Is Part Of: International journal of pediatric otorhinolaryngology. Volume 104(2018:Jan.)
• Page Start: 43
• Page End: 46
• Publication Date: 2018-01
• Subjects: Oronasal fistula -- Mucoperiosteal flap -- Nasal regurgitation -- Hard palate; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Otolaryngology -- Periodicals; Pediatrics -- Periodicals; Oto-rhino-laryngologie -- Périodiques; Pédiatrie -- Périodiques; 618.9209751
• DOI: 10.1016/j.ijporl.2017.10.037
• Languages: English
• ISSNs: 0165-5876

Abstract

Abstract: Objective: Oronasal fistula represents a functional problem, as it may result in nasal regurgitation of food and fluids and it also leads to hypernasal speech. Many methods have been proposed for its closure with a high recurrence rate. The aim of this study was to assess the efficacy of closure of hard palate fistula by two layers of mucoperiosteal flaps. Methods: Eighteen patients with fistula of the hard palate were included. The fistula was repaired by two layers of mucoperiosteal flaps; the first layer was created from the mucoperiosteum surrounding the fistula as bilateral hinge flaps and the second layer was formed of a rotational flap based on the greater palatine artery. Pre- and postoperative clinical assessment was performed. Results: The etiology of fistulas was previous cleft palate repair in 13 patients, previous nasal septal surgery in 3 patients, and untreated sharp accidental trauma to the palate in 2 patients. All patients presented with nasal regurgitation and hypernasal speech. Complete closure of all fistulas was achieved at first attempt, with no recurrence through the follow up period. Conclusions: Closure of oronasal fistula by two layers of mucoperiosteal flaps is an effective method and it has neither complications nor recurrence.