Oronasal fistula
- Fistula closure
- 매우 어려운 complication
- Lead Nasal air escape(Hypernasality, audible nasal emission). Speech distortion, Nasal regurgitation of liquid, solid
- 0~70프로 발생
- Pittsburgh Fistula Classification system : 7 type
- Difficult to repiar / Recurrance : 65%
- Scarring, stiff tissue → difficult to work
- 수술 Technique
- Direct excision and repiar
- Furlow palatoplasty = Double oppozing Z-plasty
- FAMM flap (Facial artery myomucosal flap)
- Tongue flap
- ADM
- Buccal fat pad flap
- 중요 : prevention
- Relaxing incision
- Complete intravelar veloplasty
- Total release of tensor tendon
- Complete dissection of NV bundle
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