Tongue flap repair of cleft palate fistulae

In a series of 20 patients with palatal fistulae that were judged beyond closure with local tissue alone, the fistulae were successfully closed with tongue flaps in 17 patients (85%), 6 of whom required an additional minor procedure. The social stigma of fluid leaking from the nose was corrected in all patients and, in the older age group, several patients no longer had to wear obturators. Speech was improved in 9 patients due to a reduction in hypernasality and in 8 patients, articulation was noticeably improved. The anteriorly-based tongue flap has proved to be a reliable way of closing the difficult fistula where symptoms are sufficient to justify the attempt. The procedure was used successfully in all three children under 2 1/2 years on whom it was used.