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. 2019 Jun;18(2):317-319.
doi: 10.1007/s12663-018-1160-x. Epub 2018 Oct 13.

Purse String Suture Closure: A Useful Double-Layer Technique for Closure of an Oronasal Communication

Virendra Singh  1 , Santosh Kumar Agarwal  1 , Neha Jajodia  1 , Ashish Garg  1
Affiliations

Purse String Suture Closure: A Useful Double-Layer Technique for Closure of an Oronasal Communication

Virendra Singh et al. J Maxillofac Oral Surg. 2019 Jun.

Abstract

Introduction: Various treatment modalities are reported in the literature for the management of oronasal communication. Single-layer closure often leads to failure and persists a major concern to an operative surgeon. Therefore, double-layer closure is one of the keys to successful management of oronasal communication.

Meterial and method: A continuous intramucosal running purse string suture at submucosal depth was placed circumferentially around the defect margin with 3-0 round body polyglactin suture as a first layer. Pedicled palatal rotation axial flap based on greater palatine artery was used as the second layer of closure, above the first palatal submucosal layer.

Conclusion: Intramucosal purse string suture technique provides adjacent local tissue for closure of oronasal communication. This technique is easy and can be used as an alternative option for double-layered closure of an oronasal communication, without donor site morbidity and minimal patient discomfort.

Keywords: Oronasal communication; Palatal rotation flap; Purse string suture.

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Conflict of interest statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Linear oronasal communication measuring 2 × 0.5 cm
Fig. 2
Fig. 2
a Illustration depicting a linear oronasal communication with intramucosal purse string suture. b Complete closure of defect with purse string suture end pulled taut and tied at one end and inward movement of mucosa into nasal cavity
Fig. 3
Fig. 3
First-layer closure with purse string suture technique
Fig. 4
Fig. 4
Second-layer closure with pedicled palatal rotation flap
See this image and copyright information in PMC

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