Successful Treatment of a Persistent Oroantral Fistula via Transbuccal and Transnasal Endoscopic Debridement in a Horse.

This study presents a successful treatment approach for a large dental fracture that had led to an abnormal oral-to-sinus communication with subsequent complications in a young horse. The approach involved minimally invasive techniques that promoted healing.

Background and Case Presentation

• The research focusses on a specific case of a young Quarter Horse who had a large dental fracture fragment, which had moved into the maxillary sinus, resulting in an oroantral communication. This unusual occurrence led to food impaction and metaplastic calcification within the sinus cavity and caused facial distortion with cutaneous fistulation.
• An “oroantral communication” refers to an abnormal passage or connection between the oral cavity and the maxillary sinus, which can lead to complications such as infections, food impaction and can adversely affect feeding behavior and overall health of the animal.

Treatment Approach

• The first line of treatment involved the oral extraction of the remaining tooth fragment from the socket (alveolus). This was followed by a surgical procedure known as maxillary sinusotomy, which is designed to remove abnormal sinus contents.
• Despite the corrective measures taken, the oroantral fistula, which is a pathological canal connecting the oral cavity to the sinus, did not recover spontaneously. To address this issue, the researchers used minimally invasive approaches, involving transbuccal (through the cheek) and transnasal (through the nasal cavity) endoscopic procedures. The goal of these techniques was to encourage closure of the oroantral fistula via alveolar granulation, which is the formation of connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process.

Outcome and Implications

• The method was successful in treating the persistent oroantral fistula in the horse, demonstrating the efficacy of the minimally invasive procedures and the strategic therapeutic decisions made by the clinicians.
• The findings from this case could be beneficial to clinicians treating similar cases. Understanding the diagnostic signs and familiarising themselves with the treatment approach could facilitate better management of such conditions and lead to improved outcomes in the veterinary field.