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Repair of an oronasal fistula with a two-layer closure method involving an autogenous fascia lata graft and oral mucosal flap in a pony

Marcos Lores1Sharjah Equine Hospital, Bridge No. 6, Al Dhaid Rd, Al Atain, Sharjah.

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Thomas Yarbrough2Dubai Equine Hospital, 2 St No. 22A, Dubai, United Arab Emirates.

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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.

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.

Contributor Notes

Address correspondence to Dr. Lores (marcolores@hotmail.com).