Singh, Sunil KumarGoit, BipuleshThapa, SwostiPradhan, LeezaShakya, Pramila2026-07-092026-07-092025https://hdl.handle.net/20.500.14572/6922Sunil Kumar Singh Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital / PHECT-NEPAL, Kirtipur, Kathmandu, Nepal Bipulesh Goit Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital / PHECT-NEPAL, Kirtipur, Kathmandu, Nepal Swosti Thapa Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital / PHECT-NEPAL, Kirtipur, Kathmandu, Nepal Leeza Pradhan Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital / PHECT-NEPAL, Kirtipur, Kathmandu, Nepal Pramila Shakya Department of Burns, Plastic and Reconstructive Surgery, Kirtipur Hospital / PHECT-NEPAL, Kirtipur, Kathmandu, NepalAbstract: Palatal fistula is a common and challenging complication following cleft palate repair, particularly in recurrent cases with scarred local tissues. The buccinator myomucosal flap (BMMF) provides a well-vascularized regional option for fistula closure. We report a 17-year-old male with a wide recurrent palatal fistula following multiple cleft palate surgeries. The defect, extending from the hard–soft palate junction to the pre-alveolar region, was reconstructed using a posteriorly based unilateral BMMF after nasal layer closure. The flap provided adequate reach and tension-free oral lining. Postoperative recovery was uneventful, with minimal donor-site morbidity. At four-year follow-up, the patient demonstrated stable fistula closure, healthy mucosalization, and no functional complications.en-USBuccinator myomucosal flapCleft palatepalatal fistularecurrent fistulaArticle