Sinocutaneous fistula repair with a masseter muscle transposition flap combined with wound matrix and cancellous bone graft in a horse: A new technique.
Abstract: To describe a new technique to repair a sinocutaneous fistula with a masseter muscle transposition flap. Methods: Case report. Methods: One 13-year-old thoroughbred stallion. Methods: One 13-year-old stallion with a 3.5 × 6-cm sinocutaneous fistula over the right caudal maxillary sinus was treated with a transpositional masseter muscle flap. This repair consisted of a commercial wound matrix dressing placed directly over the hole in the maxilla and secured with suture material; a cancellous bone graft collected from the right tuber coxa placed on the dressing; and a portion of the superficial layer of the masseter muscle, with its pedicle at the facial crest, transposed dorsally over the bone graft, followed by a rotational skin flap with skin rostral to the fistula to close the defect. Results: Seroma formation and dehiscence of the skin flap occurred, but the transposed muscle flap survived, and the technique resulted in successful closure of the sinocutaneous fistula with excellent cosmetic and functional outcome. Conclusions: A chronic maxillary sinocutaneous fistula was successfully treated by using a transposition flap of the masseter muscle and a rotational skin flap with minor complications. Conclusions: Transposition of the superficial layer of the masseter muscle should be considered for a repair of large maxillary sinocutaneous fistulas in horses.
© 2019 The American College of Veterinary Surgeons.
Publication Date: 2019-11-21 PubMed ID: 31750552DOI: 10.1111/vsu.13352Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Case Reports
- Journal Article
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research article abstract presents a novel technique for repairing a sinocutaneous fistula in a horse utilizing a masseter muscle transposition flap, wound matrix, and cancellous bone graft. The researchers demonstrated the success of this method in a case study involving a 13-year-old stallion and suggest its potential application for large maxillary sinocutaneous fistula repairs in horses.
Research Methodology
- The case study revolves around a 13-year-old stallion suffering from a 3.5 × 6-cm sinocutaneous fistula over the right caudal maxillary sinus. This condition was treated using a novel method that involved a transpositional masseter muscle flap.
- The repair process involved the placement of a commercial wound matrix dressing over the hole in the maxilla, secured with suture material. A cancellous bone graft, collected from the right tuber coxa of the horse, was layered over the dressing.
- A portion of the superficial layer of the masseter muscle was then transposed dorsally over the bone graft. This was complemented with a rotational skin flap, created with skin rostral to the fistula, to close the defect.
Results
- Post-operation, the horse experienced seroma formation and dehiscence of the skin flap, indicating complications. However, the transposed muscle flap survived these challenges.
- The new technique resulted in a successful closure of the sinocutaneous fistula, with the horse showing excellent cosmetic and functional outcomes.
Conclusions
- The researchers concluded that the transposition flap of the masseter muscle combined with a rotational skin flap effectively treated the horse’s chronic maxillary sinocutaneous fistula, despite minor complications.
- They propose that transposition of the superficial layer of the masseter muscle is a valuable consideration for large maxillary sinocutaneous fistula repairs in horses, potentially providing enhanced treatment options for such complex disorders in equine medicine.
Cite This Article
APA
Yoshimura S, Barber SM, Tucker ML, Bracamonte JL, Mund SJK, Thomas KL.
(2019).
Sinocutaneous fistula repair with a masseter muscle transposition flap combined with wound matrix and cancellous bone graft in a horse: A new technique.
Vet Surg, 49(4), 818-824.
https://doi.org/10.1111/vsu.13352 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
MeSH Terms
- Animals
- Bone Transplantation / veterinary
- Cancellous Bone / transplantation
- Fistula / surgery
- Fistula / veterinary
- Horse Diseases / surgery
- Horses
- Male
- Masseter Muscle / surgery
- Postoperative Complications / veterinary
- Plastic Surgery Procedures / methods
- Plastic Surgery Procedures / veterinary
- Surgical Flaps / veterinary
References
This article includes 20 references
- Barber SM, Stashak TS. Management of wounds of the head.. 2009:273-332.
- Schumacher J, Auer JA, Shamis L. Repair of facial defects with periosteal flaps in two horses.. Vet Surg 1985;14:235-239.
- Charman RE, Vasey JR. Repair of sinocutaneous fistulae in two horses.. Aust Vet J 2007;85:341-344.
- Velde K, Linsbichler B, Egerbacher M, Stashak T. Use of reversed periosteal flaps in the repair of large nasocutaneous fistulas in two horses.. Equine Vet Educ 2011;23:235-241.
- Waldridge BM, Bradley DM, Scardina MS, Swaim SF, Schumacher J. Repair of a sinocutaneous fistula in a horse using a mucosal-lined myocutaneous transposition flap.. Equine Pract 1997;19:7-11.
- Campbell ML, Peyton LC. Muscle flap closure of a frontocutaneous fistula in a horse.. Vet Surg 1984;13:185-188.
- Dart A, Best P, Peatfield J. Reconstruction of a maxillary sinus defect in a horse using a levator nasolabialis muscle flap.. Aust Vet J 1994;71:379-380.
- Anderson SL, Kelmer G. Closure of a sinocutaneous wound with a musculoperiosteal pedicle in a horse.. Vet Rec 2010;15(166):627-628.
- Antoniades K, Lasaridis N, Vahtsevanos K, Hadjipetrou L, Antoniades V, Karakasis D. Superiorly based and island masseter muscle flaps for repairing oropharyngeal defects.. J Craniomaxillofac Surg 2005;33:334-339.
- Bande CR, Mishra A, Gupta MK, Goel M, Gawande MJ. Utility of superiorly based masseter muscle flap for postablative retromaxillary reconstruction.. J Oral Maxillofac Surg 2017;75:224.e1-224.e9.
- Sivagurunathan A, Boy SC, Steenkamp G. A novel technique for ventral orbital stabilization: the masseter muscle flap.. Vet Ophthalmol 2014;17:67-72.
- Auer JA, von Rechenberg B, Bohner M, Hofmann-Amtenbrink M. Bone grafts and bone replacements.. 2012:1081-1096.
- Budras KD, Sack WO, Rock S, Horowitz A, Berg R. Anatomy of the Horse.. 2012.
- Suzuki T. Arterial supply of the masseter muscle in horse [in Japanese].. Nihon Juigaku Zasshi 1982;44:503-510.
- Sisson S, Grossman JD, Getty R. Sissson and Grossman's The Anatomy of the Domestic Animals.. Vol 384. 5th ed. 1975.
- el-Barrany WG, Marei AG, Vallée B. Anatomic basis of vascularised nerve grafts: the blood supply of peripheral nerves.. Surg Radiol Anat 1999;21(2):95-102.
- Maki Y, Firrell JC, Breidenbach WC. Blood flow in mobilized nerves: results in a rabbit sciatic nerve model.. Plast Reconstr Surg 1997;100(3):627-633.
- Lundborg G. Structure and function of the intraneural microvessels as related to trauma, edema formation, and nerve function.. J Bone Joint Surg Am 1975;57(7):938-948.
- Best TJ, Mackinnon SE, Midha R, Hunter DA, Evans PJ. Revascularization of peripheral nerve autografts and allografts.. Plast Reconstr Surg 1999;104(1):152-160.
- Badylak SF, Freytes DO, Gilbert TW. Extracellular matrix as a biological scaffold material: structure and function.. Acta Biomater 2009;5(1):1-13.
Citations
This article has been cited 1 times.- Williams ZJ, Pezzanite LM, Hendrickson DA. Review of skin grafting in equine wounds: indications and techniques. Equine Vet Educ 2024 Sep;36(9):484-493.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
