Incorporation of a polydioxanone absorbable plate in the successful repair of an iatrogenic oronasal fistula in a dog.

Abstract

CASE DESCRIPTION: A 10-year-old castrated male Siberian Husky that had undergone complete excision of an oral plasmacytoma was evaluated because of development of a large oronasal fistula following failure of primary defect repair. CLINICAL FINDINGS: Clinical examination findings for the dog were unremarkable. The dog was receiving nutrition via an esophagostomy tube, which had been placed at the time of mass excision. The dog was notably head shy. Intraoral examination following sedation revealed a large (approx 25 × 20-mm) oronasal fistula, which was oriented craniocaudally in the long axis and located at the rostral aspect of the soft palate. Maturation of tissues had been allowed following failure of the primary repair, and an epithelialized border was identified circumferentially. TREATMENT AND OUTCOME: 10 weeks after mass excision, revision surgery involving 2-layer closure augmented with a polydioxanone plate was performed. At a recheck examination 21 days after revision surgery, near-complete healing of the closure site with no repair compromise was evident, and the dog had returned to oral food intake. A follow-up evaluation 40 weeks later revealed complete healing, with a single 1-mm defect at the medial aspect of the left maxillary dental arcade, as a result of suspected repeated trauma at the level of teeth 209 and 210. This defect was not associated with any clinical abnormalities. CLINICAL RELEVANCE: The outcome for this dog indicated that use of a polydioxanone plate offers a means of robust, long-lasting, and absorbable augmentation of a traditional 2-layer repair of an oronasal fistula in this species.