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

  • Virendra Singh
  • Santosh Kumar AgarwalEmail author
  • Neha Jajodia
  • Ashish Garg
Technical Note



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.


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.


Oronasal communication Purse string suture Palatal rotation flap 


Compliance with Ethical Standards

Human Rights 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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2018

Authors and Affiliations

  • Virendra Singh
    • 1
  • Santosh Kumar Agarwal
    • 1
    Email author
  • Neha Jajodia
    • 1
  • Ashish Garg
    • 1
  1. 1.Department of Oral and Maxillofacial SurgeryPost Graduate Institute of Dental SciencesRohtakIndia

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