Large tongue flaps to close massive palatal defects

Ten patients with large palatal fistulae due to various etiologies are pres ented. The surgical technique used to close these defects and the periopera tive management are both discussed. Closure was successful in all but one. Two patients had small fistulae which required minor repairs. Two patients had bone grafts which were inserted through the flap at a second stage, wit h subsequent placement of osseointegrated dental implants.