title: Treatment modalities for surgical management of anterior palatal fistula: Comparison of various techniques, their outcomes, and the factors governing treatment plan: A retrospective study.
abstract: OBJECTIVE
  Aim of this retrospective study was to access the various surgical treatment options available for repair of Anterior palatal fistula depending upon their size and presenting age, and also to anticipate the treatment outcome.
  
  
  METHODS
  The series include study report of forty patients with secondary anterior palatal fistula post cleft palate repair, reported in a single unit during a duration of 3 years. All the cases were managed surgically under general anesthesia. The patients were classified depending upon the location of anterior palatal fistula (APF), the quality of tissue and age of patients to chalk out a justified treatment option outlay.
  
  
  RESULTS
  Forty cases were split for surgical correction into various options depending on their size, site, and quality of the tissue. Most of the cases were operated with a Bardach's Redo for fistula closure (n= 16) (40%) and crevicular flap technique (n= 13) (32.5%). Our overall success (satisfactory results) was 77.5% as observed in 31 out of 40 cases with individual success rates for Bardach's and crevicular being 75% and 77%, respectively. There was reduction in size of fistula in three cases (7.5%) and a remnant pinpoint hole in four cases (10%) among all the operated cases.
  
  
  CONCLUSIONS
  Management of post palatoplasty fistulas of the hard palate presents a challenging situation for a clinician following the surgical correction of cleft palate. Current paper describes the diagnosis and clinical management of forty cases reporting with unilateral APF following cleft palate surgery, over 3 years. Authors have attempted to propose different treatment modalities for surgical management of unilateral APF. It was concluded in the primary review that the size of fistula was irrelevant in determining the clinical outcome. Instead, the quality and condition of the adjacent tissue appear to be the major governing factors for selecting treatment modality as well as the surgical consequences.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Bangalore Institute of Dental Science, Bengaluru, Karnataka, India; Department of Oral and Maxillofacial Surgery, Smile Train-Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
authors.forename: Krishnamurthy
authors.initials: K
authors.lastname: Bonanthaya
authors.affiliation: Department of Oral and Maxillofacial Surgery, Bangalore Institute of Dental Science, Bengaluru, Karnataka, India; Department of Oral and Maxillofacial Surgery, Smile Train-Bhagwan Mahaveer Jain Hospital, Bengaluru, Karnataka, India.
authors.forename: Pritham
authors.initials: P
authors.lastname: Shetty
authors.affiliation: Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, New Delhi, India.
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Sharma
authors.affiliation: Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Ahlawat
authors.affiliation: Department of Oral and Maxillofacial Surgery, ESIC Dental College and Hospital, New Delhi, India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Passi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Uttaranchal Dental and Medical Research Institute, Dehradun, Uttarakhand, India.
authors.forename: Mahinder
authors.initials: M
authors.lastname: Singh
keywords: Anterior palatal fistula; cleft palate; tongue flap