A study of cleft palate cripple and its management with tongue flap

Introduction

The incidence of post palatoplasty palatal fistula has been reported to range from 8.7% to 23%. Due to multiple attempts at fistula closure the palatal tissue surrounding the fistula is scarred. Any further attempt to close the fistula using the local flap of scar based on the scarred pedicle is destined to be a failure.Hence we formulated a protocol of using the tongue flap to ensure successful outcome.

Patients and methods

This is a prospective study Cases of palatal fistula that were referred to our centre from January 2012 to December 2017.Patients who underwent more than two procedures and with a persistent fistula of more than 5 mm in size were classified as cleft palate cripple and included in the study.During this period  we operated  15 cases of cleft palate cripple. The size of the fistula ranged from 5 mmm to 5 cm.Tongue flap was done in all the cases.There was no case of flap dehiscence or flap necrosis.

Conclusion

Though the management of recurrent palatal fistula is a surgical challenge, closure of the fistula using distant vascularised tissues as tongue flap offers a predictable solution.