Fechamento de fístula nasopalatina com retalho de língua

Abstract

The incidence of nasal palatal fistula, which occurs during the embryonic period, happens in 1 in 650 live births in Brazil. Even with primary surgical treatments, the fistula may persist, requiring new procedures for correction and complete closure. Currently, despite advances in the health field, there are treatments and techniques that are not known or used, such as fistula closure using the pedicled tongue flap technique. This paper consists of reporting a case using this surgical technique. Even with other techniques available, the tongue flap prevails, due to its effectiveness in complex cases such as the one to be reported large and recurrent fistulas that were not successfully closed with others procedures performed previously. Even though this technique is slightly unknown, its advantages are essential for providing well vascularized and malleable tissue, an indispensable characteristic for a well healed procedureproviding a robust blood supply, crucial for regenerating issue in regions that suffer from certain difficulties in healing, such as the palate. Although other techniques did not result in complete closure, the use of the pedicled flap proved essential not only for surgical success, but also for solving the symptoms that afflicted the patient, such as nasal regurgitation and speech difficulties. This report highlights the importance of the technique in cases of complex or difficult-to-treat fistulas. Although challenging, especially due to postoperative care, it provides a safe and definite solution, not yet previously achieved, with other conventional surgical methods.