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The Vertical Proximally Based Turn Over Gingivolabial Myomucosal Flap for Closure of Anterior Palatal Fistula

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.