Parachute Technique: A New Endoscopic Method for Closing Recurrent Oronasal Fistulas in Cleft Palate Patients

Objective: To present an innovative endoscopic method, the "Parachute Technique," for effectively closing recurrent oronasal fistulas in cleft palate patients using autologous tissue. Summary Background Data: Oronasal fistulas are common complications after cleft palate repair, often leading to impaired quality of life due to difficulties with speech, eating, and an increased risk of infections. Current surgical methods exhibit high recurrence rates, especially in cases involving significant scarring or large defects. Therefore, there is a need for new techniques that improve outcomes and reduce recurrence. Methods: The study introduced the "Parachute Technique," which uses autologous tissue from the inferior nasal turbinate to create a mucosal flap. This flap is transposed through the fistula using a guidewire under endoscopic guidance. The endoscopic approach minimized trauma to the surrounding tissues and allowed for precise manipulation during the procedure. Results: The "Parachute Technique" successfully closed recurrent oronasal fistulas, particularly in cases where conventional surgical methods had failed. The use of autologous tissue reduced the immunological risks, while the minimally invasive nature of the endoscopic procedure decreased the postoperative morbidity and improved the healing outcomes. Conclusions: The "Parachute Technique" offers a promising alternative for the treatment of recurrent oronasal fistulas in cleft palate patients, providing a minimally invasive, effective solution that can be easily adopted by specialists across multiple surgical disciplines.