The sandwich technique for closure of a palatal fistula

A full-thickness fistula of the hard palate can be closed by various method s. Recurrences are seen many times and more stable methods of closure have been researched. The authors attempted to close a palatal fistula by adheri ng to the main rule of reconstruction ai stated by Gillies, "replace the lo st tissues in kind." They used a buccinator musculomucosal transposition fl ap for the nasal lining, a cranial bone graft for the palatal bone, and a l ocal mucoperiosteal transposition flap for the oral closure. The flaps and bone adapted well to the fistula. There were no recurrences during 12 month s of follow-up. This "sandwich flap"-a three-layer closure-is a reliable te chnique for the repair of a full-thickness palatal fistula.