The use of surgical template for palatal fistula repair in cleft palate using tongue flap: 3 case report

Introduction and importance: The occurrence of a palatal fistula after surgical correction in a cleft palate patient is the most common complication in cleft palate surgery. This condition might be due to poor tissue quality and vascularity, an error in the surgical technique, the size of the defect, the age of the patient, and infection. Case presentation: Three patients with fistula in the anterior and mid-palate regions asked for correction. In past history, all cases had received multiple surgical corrections, and the result showed with recurrent fistula. Discussion: Surgical interventions for correction of palatal fistula might be difficult as the surrounding tissue has lost its quality, especially in secondary surgery or after multiple surgical interventions. Flap taken from the tongue can be chosen as an alternative source to close the fistula based on the consideration that the tongue has a favourable position, and located as the nearest tissue directly opposite to the palatal region, and has good vascularity. The aim of this report is to show the advantages of the use a surgical template made from alumina foil to measure the size and shape of the flap in accordance with the form and size of existed fistula. The surgical template was used as a guidance during drawn the design of the flap on the surface of the tongue. Conclusion: The use of surgical templates was very useful as guidance during the marking procedure on the surface of the tongue for designing an individual tongue flap form.