# Impacted Ectopic Maxillary Incisor at the Margins of an Oronasal Palatal Fistula

## TL;DR

A 10-year-old child had a nasal regurgitation issue due to an impacted tooth at a surgical repair site, which was resolved by removing the tooth and repairing the fistula.

## Contribution

The case highlights the rare cause of oronasal fistula recurrence due to an impacted maxillary incisor.

## Key findings

- An impacted maxillary incisor was identified as the cause of a persistent oronasal fistula.
- A two-layered repair technique using bilateral mucoperiosteal flaps successfully closed the fistula after tooth removal.

## Abstract

An oronasal fistula is one of the most common complications that can occur after cleft palate surgeries. Some of the reasons for the failure of repair are the closure of palatal flaps under tension, vascular compromise, and infection. We present a case of a 10-year-old patient who experienced nasal regurgitation during feeding, four years after undergoing a redo palatoplasty. The reason was identified as an impacted maxillary incisor located at the fistula site. The patient was managed with the closure of the oronasal palatal fistula, with a two-layered repair technique using bilateral mucoperiosteal flaps after the removal of the impacted tooth.