Peer-reviewed veterinary case report
Repair of an oronasal fistula with a two-layer closure method involving an autogenous fascia lata graft and oral mucosal flap in a pony.
- Journal:
- Journal of the American Veterinary Medical Association
- Year:
- 2020
- Authors:
- Lores, Marcos & Yarbrough, Thomas
- Species:
- horse
Plain-English summary
A 9-year-old male pony was having problems after a tooth extraction six months earlier, which led to a suspected hole between its mouth and nose called an oronasal fistula. The pony had a smelly discharge from one nostril and bad breath, and a vet found a small defect in its mouth where food was getting stuck. After an initial surgery to fix the hole, it came back after five months, so the pony underwent a new surgical technique that used a piece of its own tissue to help close the fistula. This new method worked well, suggesting it could be a good option for similar issues in other horses.
Abstract
CASE DESCRIPTION: A 9-year-old pony gelding was evaluated because it was suspected that a persistent oronasal fistula had developed after a fractured right maxillary second premolar tooth had been extracted via repulsion 6 months earlier. CLINICAL FINDINGS: Unilateral mucopurulent nasal discharge and malodorous breath were noted on clinical examination. Examination of the oral cavity revealed a 1 × 0.5-cm defect at the oral aspect of the right maxillary second premolar alveolus, from which feed material was extracted. Endoscopic examination revealed feed material in the rostral aspect of the right nasal cavity, confirming the diagnosis of oronasal fistula. TREATMENT AND OUTCOME: The pony initially underwent a reconstructive surgical procedure that combined an alveolar bone flap with a sliding mucoperiosteal hard palate flap to repair the oronasal fistula. The fistula reoccurred 5 months later and was ultimately repaired by means of a novel 2-layer flap closure method involving an autogenous fascia lata graft and oral mucosa flap. CLINICAL RELEVANCE: Fascia lata was effective as a scaffolding graft for repair of the oronasal fistula in this pony and may be useful for repair of oronasal fistulas in other equids as well.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/31999513/