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Closure of oronasal fistula by palatal rotational flap: case report with two years follow-up

Balkan Journal of Dental MedicineOctober 13, 2022October 13, 2022

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Toptaş Orçun, Bulut Sinan, Canbolat Murat

Surgery Abant Izzet Baysal University, Faculty of Dentistry, Department of Oral and Maxillofacial, Bolu, Turkey

Summary

Background/Aim: Hard palate fistulas are due to pathologies such as noma, syphilitic gom, leprosy, leishmaniasis, radiotherapy, removal of cysts or tumors of the sinus or palate, trauma or tooth attraction. Symptoms of palatal fistulas include hypernasality in the phonation due to nasal air escape during a speech, nasal cavity fluid flow, and infection due to food accumulation. Surgical repair of palatal perforations is technically difficult and complicated. Different surgical methods can be used depending on the size and location of the defect. Among these techniques, the locoregional flap types used are palatal flap, nasolabial flap, a buccal fat pad and tongue flap. Case Report: In this case report, we presented a patient with oronasal fistula due to a previous surgical operation, which was surgically closed by a palatal rotational flap. Conclusions: As a result, the oronasal communucation was relieved by successful closure of the defect and the donor area healed uneventfully.

Keywords: Oronasal Fistula; palatal rotational flap; surgical closure

Reference

Block, M.S. (1997) Use of local flaps in intraoral reconstructive surgery. Philadelphia, 2. ed., 947-985

Cohen, S.R., Kalinowski, J., Larossa, D., Randall, P. (1991) Cleft palate fistulas: A multivariate statistical analysis of prevalence, etiology, and surgical management. Plast Reconstr Surg, 87, 1041-1047

Ducic, Y., Herford, A.S. (2001) The use of palatal island flaps as an adjunct to microvascular free tissue transfer for reconstruction of complex oromandibular defects. Laryngoscope, 111(9), 1666-1669

Genden, E.M., Lee, B.B., Urken, M.L. (2001) The palatal island flap for reconstruction of palatal and trigonum retromolare defects revisited. Arch Otolaryngol Head Neck Surg, 127, 837-841

Honnebier, M.B.O.M., Johnson, D.S., Parsa, A.A., Dorian, A., Parsa, F.D. (2000) Closure of palatal Fistula with a local mucoperiosteal flap lined with buccal mucosal graft. Cleft Palate-Craniofacial Journal, 37(2), 127-129

Rao, Y., Yadav, P., Singh, J., Patel, D., Aggarwal, A. (2013) Surgical and prosthetic management of suction cup induced palatal perforation: Case report. Journal of clinical and diagnostic research, 7, 2086-2087

Rintala, A. (1971) A double, overlapping hinge flap to close palatal fistula. Scandinavian Journal of Plastic and Reconstructive Surgery, 5(2), 91-95

Sahoo, N.K., Desai, A.P., Roy, I.D., Kulkarni, V. (2016) Oro-nasal communication. Journal of Craniofacial Surgery, 27(6), e529-e533

Schultz, C.R. (1986) Management and timing of cleft palate fistula repair. Plastic and Reconstructive Surgery, 78(6), 739-745

Turk, A.E., Chang, J., Soroudi, E.A., Hui, K., Lineaweaver, W.C. (2000) Free flap closure in complex congenital and acquired defects of the palate. Annals of Plastic Surgery, 45(3), 274-279

Vaaka, P., Donga, S.K., Ganapathi, A.K., Priya, B., Kaluvakolanu, S., Mohammad, Z. (2016) Suction cup induced palatal fistula: Surgical closure by palatal rotational flap. Annals of Medical and Health Sciences Research, 6(2), 129-132

Wilhelmi, B.J., Appelt, E.A., Hill, L., Blackwell, S.J. (2001) Palatal fistulas: rare with the two-flap palatopasty repair. Plastic and Reconstructive Surgery, 107(2), 315-318

Balkan Journal of Dental Medicine, 2019, vol. 23, br. 2, str. 98-101

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