The anteriorly based dorsal tongue flap was introduced by Guerrero-Santos and Alta-mirano in 1966 for the surgical closure of a large palatal fistula.1 Now, it is a well-accepted method for treating cleft palate patients who have oronasal fistulas that cannot be closed using local tissue alone. Many authors have encountered spontaneous detachment of the tongue flap during the early postoperative period; however, there is no described treatment protocol for such a situation. Generally, it is believed that little or nothing can be done for intraoral ground breakdown, which commonly becomes ipiected and inflamed very quickly, so secondary suturing is not an effective treatment,4 Like many other authors, we too have encountered postoperative detachment of the tongue flap that has been used to close a large anterior oronasal fistula. In one of our patients, we salvaged and reattached the detached tongue flap using a simple surgical procedure and a simple postoperative management protocol. Considering the high risk of flap detachment, we have successfully used the same technique primarily in another patient with a large anterior oronasal fistula.
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