Use of a buccal musculomucosal flap to close palatal fistulae after cleft palate repair.

Forty-two patients aged 4 to 13 (mean 7 years) had palatal fistulae closed with a buccal musculomucosal flap. The pedicle was divided approximately 2 weeks after the initial operation. Complete closure at the first attempt was obtained in 69% of the cases though, when the fistulae were large and extended to the anterior hard palate, the results were not as good (36%). Almost no detrimental after-effects occurred at the donor site. The buccal musculomucosal flap was found to be a useful alternative to a tongue flap.