Closure of difficult palatal fistulas using a "parachuting and anchoring" technique with the tongue flap

The tongue flap has been described in reconstructing palatal defects. Nevertheless, properly securing the flap to the palatal defect has continued to pose a challenge, especially because the flap becomes mobile with normal activities (i.e., speech and swallow). For this reason, alternative fixation schemes have been discussed in literature, but do not always solve the problem. In this article, we offer an alternative method for positioning and securing the tongue flap into the palatal defect. The authors of this article believe that advantages of this technique include an increase in flap security and immobility and a decrease in postoperative maxillomandibular fixation requirement. Although unanswered questions still remain regarding improved flap retention with this method, we believe that the "parachuting and anchoring" technique provides an alternative method that can most definitely add to the surgeon's armamentarium.