Pedicled "flap" from a tongue flap

A pedicled musculo-mucocutaneous "flap" derived from an original tongue flap is used as one of the layers for the double-layered closure of a recurring oro-nasal fistula. The other layer used for the closure, namely the nasal "flap" layer, originates from the adjacent palatal mucoperiosteum. The oral pedicled "flap" layer and the nasal "flap" layer form the final double-layered flap. This technique gives satisfactory closure of the persistent oro-nasal fistula.