Oronasal Fistula Flashcards
What is an Oronasal Fistula
An oronasal fistula is an abnormal passageway between the mouth and the nasal cavity, more commonly seen in the upper canine area.
How is this picked up?
This is often picked up when the animal is eating and drinking, as food and fluid enters the respiratory tract and causes sneezing.
Diagnosis
If the patient is diagnosed with an oronasal fistula, this must be repaired surgically as these will not heal on their own. Oronasal fistulas appear to form more readily in dolichocephalic breeds than mesocephalic or brachycephalic breeds.
This procedure is considered dirty and should be performed at the end of the day, or in a separate dental room.
Patient Positioning
The patient is placed in lateral recumbency with the affected area uppermost. Positioning requirements will need to be discussed with the veterinarian.
Patient prep
Swabs should be placed into the oropharynx and the fistula can be flushed with diluted chlorhexidine. This should be done with the patient’s head tilted slightly so the solutions do not drain down into the trachea
Instrument / Materials
A dental kit (periodontal probe usually is enough), swaged on PDS or Vicryl and saline is required.
Surgical Procedure
The veterinarian will use a periodontal probe to investigate the fistula. Saline may be required to flush into the fistula; if the saline comes out of the corresponding nostril this indicates there is communication.
The canine is extracted and the site is flushed to remove debris. The defect is closed using a long lasting swaged on suture of Polydioxanone (PDS11).
This suture is a absorbable monofilament and only loses 14% of its tensile strength at 14 days, taking 180 days to fully absorb
Post op care
Soft food should be provided for 10 days, antibiotics and pain relief are administered by the owners at home, and a revisit is organised to assess healing.
