Palatonasal and Bucconasal Fistula Closure Surgery

Initial Presentation:

The patient presented at Balaji Dental and Craniofacial Hospital, Teynampet, Chennai with complaints of regurgitation of fluids from the oral cavity into the nose for a very long time. The patient stated that there were “two holes” in the bone on the right side of his upper jaw.

Diagnostic Tests:

Dr. SM. Balaji, Cranio-Maxillofacial Surgeon, examined the patient and ordered radiographic studies for diagnostic confirmation. He explained to the patient that the “two holes” were oronasal fistulae that were connections between the oral cavity and the nasal cavity. He further explained how these were causing the patient’s regurgitation problems. He added that surgical correction was the only solution for this. The patient was in agreement with this plan of treatment and was scheduled for surgery.

Surgical Procedure:

Under general anesthesia, a palatal flap was raised for closure of the palatonasal fistula. The epithelialized portion of the fistulous tract was excised and tissue was mobilized around the fistula, which was then closed with the palatal flap. Following this, a mucogingival flap was raised for closure of the bucconasal fistula. The epithelialized portion of the fistulous tract was excised followed by mobilization of the tissue around the fistula. The flap was then utilized to close the fistula. The patient was then extubated and recovered uneventfully from general anesthesia.