The use of buccal flap in the closure of posterior post-palatoplasty fistula.

OBJECTIVE: Palatal fistulation is a common complication after cleft palate repair, it could occur at any site along the line of cleft closure. Many techniques have been proposed for its repair. However, the incidence of recurrence after initial fistula closure is high. The aim of this study is to evaluate the efficacy of closure of posterior palatal fistula using buccal myomucosal flap.

METHOD: Fifteen cases with posterior palatal fistulas - after cleft palate repair - were included in this study. Their fistulas were closed in two-layers; an oral mucoperiosteum hinge flap to reconstruct the nasal side and a buccal myomucosal flap from the inner surface of the cheek to reconstruct the oral side. Follow-up was carried out for 1 year.

RESULTS: The fistulas were completely closed in all cases (100%) with no failure or recurrence. This was a single-stage operation in all cases, with no need for further procedure to divide the pedicle of the flap.

CONCLUSIONS: Closure of posterior palatal fistula using buccal myomucosal flap in addition to mucoperiosteal flap is a useful method with high success rate and no morbidity.