Evaluation of the role of tongue flap in recurrent large palatal fistula repair

Background: The formation of the palatal fistula is a known complication of palatoplasty. The most frequent risk factors are
vascular accidents, poor surgical technique, or even infection. However, large recurrent fistula showed poor prognosis with
local flaps.
Objective: This study aims to evaluate the role of tongue flap in recurrent large palatal fistula repair.
Patients and Methods: The author recruited 15 pediatric patients during a period of fourteen-month. The primary diagnosis of
the included sample was a non-native recurrent palatal fistula. Tongue flap repair of the recurrent palatal fistula was performed
in all 15 patients. The flaps were separated after three weeks, and the final inset was done. Flap viability, fistula closure, residual
tongue function, operation time, and speech problems were assessed.
Results: In all the patients, the fistula was closed primarily by tongue flap. None of the patients developed flap necrosis.
Neither donor-site morbidity nor functional deformity of the tongue was seen. The operative time ranged from 40 minutes up to
60 minutes in 87 % of the patients. The speech was improved in all cases.
Conclusion: The excellent vascularity, central position, mobility, and versatility of the tongue flap make it the perfect choice for
repairing large fistula in palates injured by previous surgery. Children very well tolerate it. We, therefore, recommend tongue
flap for large recurrent palatal fistula in children.