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

This research demonstrates the successful treatment of a persisting oronasal fistula in a pony through a two-layered surgical method involving an autogenous fascia lata graft and oral mucosal flap, following a previously failed traditional repair procedure.

Case Presentation and Examination Findings

• The study presents a case of a 9-year-old gelding pony that was suspected to have developed a persistent oronasal fistula as a result of a tooth extraction procedure conducted 6 months prior.
• Clinical examination revealed symptoms including unilateral mucopurulent nasal discharge and malodorous breath.
• A defect was found at the oral aspect of the right maxillary second premolar alveolus, which was suspected to be the cause of the feed material found therein. Examination concluded the defect was causing an oronasal fistula.

Initial Treatment Attempt and Recurrence

• As a first attempt to treat the oronasal fistula, a reconstructive surgical procedure was performed. This procedure involved the creation and application of an alveolar bone flap alongside a sliding mucoperiosteal hard palate flap.
• Despite this procedure, the oronasal fistula reoccurred after 5 months, indicating the initial surgical approach was unsuccessful in providing a long-term solution.

Novel Two-Layer Closure Method

• In response to the recurrence of the fistula, a unique two-layer flap closure method was adopted. This technique involved the use of an autogenous fascia lata graft and an oral mucosal flap. An autogenous graft implies the tissue was sourced from the pony itself.
• This innovative surgical approach proved successful, effectively treating the oronasal fistula without subsequent recurrence.

Conclusions and Recommendations

• The study concludes that the autogenous fascia lata was effective as a graft for repairing the oronasal fistula in the treated pony.
• Beyond this case, the successful experimental approach suggests potential for the method’s effective use in healing oronasal fistulas in other horses or equids too.