Oral Biol Res.  2023 Dec;47(4):164-167. 10.21851/obr.47.04.202312.164.

Palatal fistula closure with lengthening of soft palate using a pedicled buccal fat and a buccinator flap: a case report

• Park YW

• KMID: 2550108
• DOI: http://doi.org/10.21851/obr.47.04.202312.164

Abstract

A 49-month-old male patient was diagnosed with a postoperative mid-palatal fistula and mild velopharyngeal insufficiency. The fistula was 7 mm in size and surrounded by contracted scar tissues. Therefore, we performed fistula closure using a pedicled buccal fat pad to reduce the risk of recurrence and posteriorly-based buccinator myomucosal flap to lengthen the soft palate. The fistula was closed using mucosalization without any complications, and patient’s hypernasality decreased after 13 months of follow-up. This surgical treatment enhanced tension-free closure of the fistula and velopharyngeal sphincter function and minimized the possibility of maxillary hypoplasia after wide dissection of the palatal mucoperiosteum. These findings suggests that buccinator myomucosal flaps and pedicled buccal fat represent a favorable treatment option for the closure of fistulae associated with veloplaryngeal insufficiency.

Keyword

Buccinator flap; Hypernasality; Palatal fistula; Pedicled buccal fat