Muscle Flap Closure of a Frontocutaneous Fistula in a Horse

Summary A 9‐year‐old Hungarian sport horse gelding was presented to the clinic in poor condition displaying malodorous bilateral purulent nasal discharge. Oral examination revealed the presence of supernumerary 111 and 211. Bilateral diastema formation between the third maxillary molars and the supernumerary teeth with deep periodontal pockets and massive food impactions were diagnosed endoscopically. Radiography revealed inhomogenous sinus opacities in the left and right paranasal sinuses. Following bilateral oral extractions of the supernumerary cheek teeth and third maxillary molars, bilateral oromaxillary fistula formations were diagnosed (about 17 mm diameter on the right side). Bilateral frontal and right‐sided maxillary trephinations and resection of the right bulla of the maxillary septum were performed. Massive food impactions of the left and right paranasal sinuses were removed under endoscopic control. Repeated trans‐endoscopic sinus lavage was performed post‐operatively. After 2.5 months, the large right‐sided oromaxillary communication was temporarily closed with a transmaxillary anchored, gauze‐cored silicon plug on an outpatient basis. Follow‐up examination after 187 days revealed complete closure of the oromaxillary fistula and absence of sinusitis. In a 1.5‐year follow‐up control, no pathological conditions were found.

Section: Discussionmentioning

confidence: 99%

Transmaxillary anchored silicon embedded gauze plug in the post‐operative treatment of a large oromaxillary fistula caused by a supernumerary cheek tooth

Hevesi¹,

Uto²,

Takacs³

et al. 2018

“…A nasocutaneous or sinocutaneous defect that is too large to heal by contraction and epithelialisation can be healed by covering it with transposed muscle, such as the superficial interscutularis and temporalis muscles(Campbell and Peyton 1984) or the levator nasolabialis muscle (Dart et al . 1994), provided that the diameter of the fistula is not larger than the diameter of the muscle to be transposed.…”

Section: Treatment Of Horses For a Nasocutaneous Or Sinocutaneous Fismentioning

confidence: 99%

“…Muscle transposed to obliterate a fistula provides vascularised tissue to the wound that can accept a pedicle skin graft (Dart et al . 1994) or a free skin graft (Campbell and Peyton 1984).…”

Section: Treatment Of Horses For a Nasocutaneous Or Sinocutaneous Fismentioning

confidence: 99%

Treatment of horses for a facial or oral fistula

Schumacher

Brink

2011

Summary A sinocutaneous or nasocutaneous fistula is usually a sequel to a comminuted fracture of one or more facial bones, whereas an oronasal or oromaxillary sinus fistula occurs most commonly after a maxillary alveolus fails to fill with healthy granulation tissue after its tooth has been lost. Horses with a sinocutaneous or nasocutaneous fistula can be treated by covering the fistula with transposed muscle, which in turn is covered by adjacent skin or a free skin graft, or by covering the fistula with periosteum transposed from adjacent bone, itself covered by adjacent skin or left uncovered to heal by second intention. Horses with an oronasal or oromaxillary sinus fistula can usually be treated successfully by temporarily occluding the oral aspect of the fistula, to prevent feed from entering the fistula, until the apical end of the alveolus fills with healthy tissue. Other methods of treatment include covering the oral aspect of the fistula with a mucoperiosteal flap or filling the fistula with a transposed facial muscle.

“…Tissue barriers that have been used for this purpose include mucosa (Waldridge et al . 1997), muscle (Campbell and Peyton 1984), skin (Madison et al . 1989) and periosteum (Schumacher et al .…”

Section: Introductionmentioning

confidence: 99%

Use of reversed periosteal flaps in the repair of large nasocutaneous fistulas in two horses

Velde¹,

Linsbichler

Egerbacher

et al. 2011

Summary Head injuries occur frequently in horses and a successful outcome after repair depends upon the severity of the initial trauma, the anatomical structures involved and the extent of tissue loss. Often these injuries involve facial bones and enter into the nasal passages or paranasal sinus system. When these injuries occur in conjunction with substantial tissue loss, the resulting defect may be difficult to close and naso/sinocutaneous fistulae can develop. These defects can be challenging and time consuming to repair and an appropriate reconstructive technique must be selected. We describe the use of reverse periosteal flaps as a technique in repairing large nasocutaneous fistulae in 2 horses after previous attempts to close the defects by other means had failed.