Background: Palatal fistula is the most common complication
following cleft palate repair. Plenty of reconstructive
procedures have been described for repair of these fistulas.
This study describes a reliable technique of vertical proximally
based turn over gingivolabial myomucosal flap for closure of
anterior palatal fistulas.
Methods: Thirty four patients presented with large sizes
anterior palatal fistulas underwent closure using vertical
proximally based turn over gingivolabial myomucosal flaps.
The procedure is a single stage with nasal layer closure while
oral layer left for re epithelialization.
Results: All flaps completely survived. Two out of 34
flaps (5.8%) suffered distal necrosis which improved after
debridement and secondary suturing but no other complications.
All fistulas were completely healed without any evidence
of recurrence during a mean follow-up period of 18 months.
Conclusion: The vertical proximally based turn over
gingivolabial myomucosal flap is a simple single stage technique.
The flap is a reliable good option for closure of anterior
fistula in presenting age groups without donor site morbidity.
It is suited for most anterior located palatal fistulas and
medium sized ones.