Management of Residual Post-traumatic Palatal Defect Resulting in Palatal Fistula: A Case Report

The typical skeletal framework that directs anatomical reductions after fixing is absent from pan facial fractures, which have a complicated pattern and are often associated with post traumatic deformities of face. Management of such conditions like depressed forehead, temporal hollowing, nasal deviation, telecanthus, loss of facial width, palatal fistulas, malocclusion is crucial when they involve functional abnormalities. Palatal fistulas following trauma, benign or malignant pathologies are debilitating conditions rendering patients difficulty in swallowing and speech impairment. This case report mainly emphasises on the management of one such defect, post traumatic residual palatal fistula. Here, a case of 43 year old male patient who was operated for facial bone fractures along with the neurosurgery team, developed a postoperative palatal fistula. Later after a month, second surgery was done, under General Anaesthesia (GA), fistula repair with palatal pedicle advancement flap was done. Postoperative outcome was satisfactory for both patient and the surgeon. Palatal pedicle advancement flap provides a robust, well vascularised, local tissue cover that allows tension free, single stage closure of the defects with good tissue match and minimal donor site morbidity.