Congenital palatal fistula is a rare embryologic anomaly, occurring in one percent of cleft cases, often causing hypernasality and nasal regurgitation. We report a 3-year-old male with an isolated fistula at the hard-soft palate junction. Repair was performed using a combined technique: a turnover hinge flap for the nasal layer and Z-plasty flaps for the oral layer. A fistula at this area is difficult to manage because of paucity of tissue. The two layer closure that we describe is a refinement of technique with practical applications.
John et al. (Tue,) studied this question.