Objective: Oronasal fistula represents a functional problem, as it may result in nasal regurgitation of food and
fluids and it also leads to hypernasal speech. Many methods have been proposed for its closure with a high
recurrence rate. The aim of this study was to assess the efficacy of closure of hard palate fistula by two layers of
mucoperiosteal flaps.
Methods: Eighteen patients with fistula of the hard palate were included. The fistula was repaired by two layers
of mucoperiosteal flaps; the first layer was created from the mucoperiosteum surrounding the fistula as bilateral
hinge flaps and the second layer was formed of a rotational flap based on the greater palatine artery. Pre- and
postoperative clinical assessment was performed.
Results: The etiology of fistulas was previous cleft palate repair in 13 patients, previous nasal septal surgery in 3
patients, and untreated sharp accidental trauma to the palate in 2 patients. All patients presented with nasal
regurgitation and hypernasal speech. Complete closure of all fistulas was achieved at first attempt, with no
recurrence through the follow up period.
Conclusions: Closure of oronasal fistula by two layers of mucoperiosteal flaps is an effective method and it has
neither complications nor recurrence.