Facial Artery Musculomucosal Flap for Closure of Fistula After Cleft Palate Surgery

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Author(s): Hassan Saeed Khan1, Farhan Gohar 2, Muhammad Aslam Khan 3, Shiza Naeem 4, Umar Iqbal5, Javeria Khan6

Pages: 5-9 | DOI: https://doi.org/10.5455/pjps.1702062656


Background: Palatal fistula is the most common complication of palatal repair. Most anterior palatal fistulas
need tongue flap for closure, which is a two-stage procedure. In this article, we have used facial artery
musculomucosal (FAMM)flap technique, for closure of anterior palatal fistula as a single stage procedure.
Methodology: Twenty-four patients with an oronasal fistula size range between 0.5-2cm² underwent the
FAMM flap procedure. Follow-up was up to 2 years, assessing flap viability, recurrent fistulas, and speech
changes.
Results: The flap showed promising outcomes, with one case of partial necrosis and no recurrent fistulas.
The procedure achieved reduction in the velopharyngeal insufficiency.
Conclusion: FAMMflap offers a reliable one-stage option for oronasal fistula repair, demonstrating minimal
complications and improved speech and oral hygiene. Further studies should assess velopharyngeal function
in patients undergoing FAMMflap.

Keywords | : Facial artery musculomucosal flap, oronasal fistula, palate reconstruction, velopharyngeal function, palate surgery.