Five case studies- Case 2

Brett December 16, 2019

Case studies that highlight the importance of timely veterinary dental referrals.

Figure 2A

Case 2: Oronasal fistula
Oronasal fistulas result from inadequate exposure and closure of maxillary extraction sites. They occur most commonly because of maxillary canine extractions, as in the dog in Figure 2A.

Figure 2B

Chronic nasal discharge (Figure 2B) and sneezing are common results of oral and nasal communication.

In this case of bilateral oronasal fistulas in a dog, closure was attempted at the time of the initial extraction. Dehiscence resulted in two additional attempts before referral. Flap tension due to inadequate exposure is the reason for most oronasal fistula repair failures.

Figure 2C

As in this case, adequate exposure, débridement (Figure 2C) and closure (Figure 2D, see next page) by a board-certified veterinary dentist is the recommended approach to resolve oronasal fistulas. Analgesics and perhaps a short course (five days) of antibiotics can complete treatment.

Bacterial culture and antimicrobial sensitivity testing may be needed in the occasional case of a patient with persistent signs. Also consider allergic rhinitis in some persistent cases.

Figure 2D