FACIAL ARTERY MUSCULOMUCOSAL FLAP FOR CLOSURE OF FISTULA AFTER CLEFT PALATE SURGERY.

Introduction: Palatal fistula is the most common complication of palatal repair. Mostly anterior palatal fistula needs tongue flap for closure, which is a two-stage procedure. In this article, we have used facial artery musculomucosal (FAMM) flap technique, for closure of anterior palatal fistula as a single stage procedure. Methods: Twenty-four patients with a oronasal fistula size range between 0.5-2cm² underwent the FAMM flap procedure. Follow-up was up to 2 years, assessing flap viability, recurrent fistulas, and speech changes. Results: The flap showed promising outcomes, with one case of partial necrosis and no recurrent fistulas. The procedure achieved reduction in the velopharyngeal insufficiency. Discussion: FAMM flap provides efficient one-stage oronasal fistula reconstruction. It holds potential, especially for patients with an anterior oronasal fistula in a single stage surgery. Conclusion: FAMM flap offers a reliable one-stage oronasal fistula repair, demonstrating reduced complications and improved speech and oral hygiene. Further studies should assess velopharyngeal function in patients undergoing FAMM flap.