Local and regional flap reconstruction of large palatal fistulae - outcomes and insights from a…

Cohort studyJournal of plastic, reconstructive & aesthetic surgery : JPRAS· Jul 2026

Local and regional flap reconstruction of large palatal fistulae - outcomes and insights from a retrospective cohort of 129 patients.

Muhammad Daiem, Haya Bajwa, Sohaib Irfan … Ghulam Qadir Fayyaz

Craniofacial & CleftCohort studyQ1IF 1.9

Combined local flap procedures independently linked to lower recurrence of large palatal fistulae

Local and regional flap reconstruction of large palatal fistulae - outcomes and insights from a retrospective cohort of 129 patients.

Muhammad Daiem … Ghulam Qadir Fayyaz

Journal of plastic, reconstructive & aesthetic surgery · Jul 2026 · Q1 in Surgery

Background

Large palatal fistulae (> 2 cm) following primary palatoplasty represent an increasingly challenging subtype, causing substantial morbidity, including oronasal regurgitation, hypernasality, and reduced quality of life.

Purpose

This study reports outcomes of local and regional flap techniques for large palatal fistulae, with a focus on recurrence, speech outcomes, and technique selection.

Methods

With large palatal fistulae (>2 cm) managed exclusively with local or regional flaps were included.

n = 129 patients

aOR 0.20

Results

aOR 0.20

combined local flap procedures independently lowered fistula recurrence risk

n = 129 patients

More results

Bardach redo-palatoplasty was used in 53.5%, buccinator myomucosal flap in 22.5%, tongue flap in 12.4%, and buccal sulcus myomucosal flap in 11.6% of cases.

Overall recurrence occurred in 20 patients (15.5%).

More results

Postoperatively, 86.1% of assessed patients achieved normal or mild resonance (G0/G1), with the mean composite speech score improving from 15.2 to 6.4.

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Conclusion

Local and regional flap reconstruction achieves encouraging outcomes in large palatal fistula repair and should be regarded as the primary reconstructive strategy for large palatal fistulae.

Local and regional flap reconstruction of large palatal fistulae - outcomes and insights from a retrospective cohort of 129 patients.

Local and regional flap reconstruction of large palatal fistulae - outcomes and insights from a retrospective cohort of 129 patients.

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