A Clinical Study On The Buccal Musculomucosal Island Flap For Palate Fistula Repair

Objective: To explore and evaluate clinical application of buccal musculomucosal island flap for palate fistula repair.Methods: The buccal musculomucosal island flaps pedicled superior-anteriorly based on the distal portion of the facial artery through the anterior buccal branches and pedicled posteriorly based on the buccal artery and posterior branches of the facial artery were designed for palate fistula repair. 18 palate fistulas were repaired by this method, 4 pedicled superior-anteriorly and 14 pedicled posteriorly, 7 of which got velopharyngeal incompetence correction at the same time.Results: All the patients got satisfactory fistula closure except 3 complications. One flap got partly necrosis and two got fistulas at the hard palate. However, the fistula sizes were reduced greatly and one has been repaired well by the transferred buccal musculomucosal flap tissue after one year. All the patients had no facial nerves injuries, no limitation in mouth opening and mastication difficulty.Conclusion: The buccal musculomucosal island flaps pedicled superior-anteriorly and posteriorly are trustworthy and safe for palate fistula repair. It can be transferred conveniently to repair palate fistula of any position. Even if a fistula re-occurred, the transferred buccal musculomucosal flaps could provide enough tissue for another surgery repair.