Closure of large oronasal fistula (ONF) in cleft patients is a challenge for patients and surgeons. The extent of functional impairment has psychologic, social, and developmental consequences. The ONF affects the feeding and speech of patients. Keys to repairing fistulas in this region are a 2-layer, tension-free closure, and an attentive suturing technique. In this article, the details and effectiveness of 2-flap palatoplasty are presented.
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