What signs indicate a fistula after palate repair?

• A. Air escaping through the palate during swallowing, nasal regurgitation, and abnormal speech resonance.
• B. Fever and rash.
• C. Decreased nasal airflow during breathing.
• D. Headache and sore throat.

Answer: (A)

A fistula after palate repair creates a direct connection between the mouth and the nasal cavity. The most telling signs come from what happens when swallowing and speaking with that pathway open. Air can escape through the palate into the nasal cavity during swallowing, which is those air leakage signs. Liquids and some foods can flow into the nasal passages during swallowing, causing nasal regurgitation. Because air and sound can pass into the nasal cavity during speech, the voice often becomes abnormally resonant, typically hypernasal.

These combined findings—air escaping during swallowing, nasal regurgitation, and abnormal (hypernasal) speech resonance—are classic indicators of a palatal fistula. Other signs like fever and rash suggest infection or systemic illness rather than a structural fistula, and decreased nasal airflow or headaches and sore throat aren’t the characteristic patterns seen with a fistula in this context.