title: Spacer Facial Artery Musculomucosal Flap: Simultaneous Closure of Oronasal Fistulas and Palatal Lengthening.
abstract: In this series, the authors describe a modification of the facial artery musculomucosal flap for oronasal fistula repair. The spacer facial artery musculomucosal flap technique is characterized by a pedicle inset into the retromolar trigone and palate, obviating a second operative stage. This was performed in 14 patients with a 5.2-cm mean fistula size. Average follow-up was 4.3 years, with one partial flap necrosis but no recurrent oronasal fistula. There was a mean decrease of 18 percent in the distance between the velum and the posterior pharyngeal wall. The spacer facial artery musculomucosal flap provides a single-stage reconstruction of oronasal fistula while lengthening the palate through a pushback mechanism. Although further study of velopharyngeal function is needed, the spacer facial artery musculomucosal flap may be beneficial for patients with a short velum and an oronasal fistula.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: New York and Valhalla, N.Y. From the Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai; and the Division of Plastic and Reconstructive Surgery, New York Medical College.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Lee
authors.forename: Kaveh
authors.initials: K
authors.lastname: Alizadeh
mesh_terms: D000293:Adolescent; D001158:Arteries / Q000637:transplantation*; D002342:Carotid Artery, External / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005145:Face / Q000098:blood supply; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008297:Male; D009061:Mouth Mucosa / Q000098:blood supply* / Q000637:transplantation; D009668:Nose Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016155:Oral Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D010160:Palate, Soft / Q000601:surgery; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D016156:Respiratory Tract Fistula / Q000000981:diagnostic imaging / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D013524:Surgical Flaps / Q000098:blood supply* / Q000637:transplantation; D016896:Treatment Outcome; D055815:Young Adult