Introduction: One of the expected outcomes of palate repair is to achieve complete partition between nasal and oral cavity in addition to good speech. Any failure of achieving complete structural integrity of palate is labelled as an oronasal (palatal) fistula with persistent passage between oral and nasal cavity, it can occur at the anterior, posterior or mid palatal region 

Aim: The aim of the study is to assess prevalence of palatal fistula, cause of palatal fistula, location of palatal fistula and to derive a more relevant surgical technique.

Methodology: A retro-prospective study was conducted in operated cleft patients who showed presence of palatal fistula between the age group of 9 months to 7 years. The data collected included age, sex and type of cleft defect type, width of cleft palate type of surgery performed, size of fistula, location of fistula, duration of fistula formation postoperatively

Results: 8 palatal fistula were included. The fistula was located mostly at the anterior palatal region (50%) and secondly at the mid palatal region (38%). The occurrence of fistula in operated cleft lip and palate cases was noted mostly after V-Y pushback palatoplasty followed by Von Langenbeck

Conclusion: Among the surgical techniques used for palatoplasty, the Von Langenbeck is proven to be superior than V-Y pushback palatoplasty in accordance with the occurrence of palatal fistula. The anterior palate fistulas were the most common type in the study.

Keywords: Cleft palatal fistula, Oronasal fistula 

Denis Jacob Kurian is an Oral and Maxillofacial Surgeon with extensive experience in clinical practice, academic teaching, and research. He holds a Bachelor of Dental Surgery (BDS) and a Master of Dental Surgery (MDS) in Oral and Maxillofacial Surgery, along with a Fellowship in Implantology.

He served as an Assistant Professor at SDM College of Dental Sciences from 2022 to 2024, where he was involved in undergraduate and postgraduate teaching, clinical supervision, and academic mentoring. His professional experience includes hospital-based surgical care, academic instruction, and peer-reviewed research.

His academic and clinical interests include maxillofacial infections, implantology, cleft-related conditions, oral pathology, and clinical outcomes research. He has authored and co-authored multiple publications in international peer-reviewed journals and remains committed to evidence-based practice, patient-centered care, and continuous professional development.