Purse String Suture Closure: A Useful Double-Layer Technique for Closure of an Oronasal Communication

Various treatment modalities are reported in the literature for the management of oronasal communication. Single-layer closure often leads to failure and persists a major concern to an operative surgeon. Therefore, double-layer closure is one of the keys to successful management of oronasal communication.

A continuous intramucosal running purse string suture at submucosal depth was placed circumferentially around the defect margin with 3-0 round body polyglactin suture as a first layer. Pedicled palatal rotation axial flap based on greater palatine artery was used as the second layer of closure, above the first palatal submucosal layer.

Intramucosal purse string suture technique provides adjacent local tissue for closure of oronasal communication. This technique is easy and can be used as an alternative option for double-layered closure of an oronasal communication, without donor site morbidity and minimal patient discomfort.