Clinical amplication of the temporoparietal-galeal flap in closure of a chronic oronasal fistula: Review of the anatomy, surgical technique, and report of a case

The reconstructing surgeon has a variety of options when closing defects of the hard and soft palate. Techniques can be as simple as a palatal island flap or as complex as the radial forearm flap. We present here a method of closing a medium to large defect of the palate using the temporoparietal-galeal (TPG) flap, a regional and very reliable flap for reconstructing defects of the oral cavity and face. The TPG is a thin and pliable flap with an axial blood supply and a good arc of rotation to the oral cavity. The flap can be used as a fascial flap, a fasciocutaneous flap, or an osteofascial flap. It provides an excellent source of vascularized tissue.