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Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment

Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment - Dogs Dental Care Articles

Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment : Dogs Dental Care Articles; Oronasal and oroantral fistulas are communications between the oral cavity and the respiratory tract. The only difference is the location of these fistulas. " src="http://www.vetarena.com/gallery/image-1014.m.jpg" /> The oronasal fistula is located more rostral (incisor, canine and premolar areas) compared to the oroantral fistulas which are situated in the caudal premolar ... Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment


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Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment

Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment

Oronasal and oroantral fistulas are communications between the oral cavity and the respiratory tract. The only difference is the location of these fistulas. Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment The oronasal fistula is located more rostral (incisor, canine and premolar areas) compared to the oroantral fistulas which are situated in the caudal premolar and molar areas.
Dolichocephalic dog breeds are more likely to be affected with this condition, especially the Dachshund. These types of fistulas are caused by the diseased condition of any tooth in the upper jaw. The most common location for an oronasal fistula is where the root of the fourth premolar on the upper jaw enters the palate. This condition will need to be surgically corrected to prevent food and water from passing from the mouth into the nasal cavity. If this should occur, it will cause irritation of the nose, runny nose, inflammation of the sinuses, infection, and possibly pneumonia.

Symptoms of Oronasal Fistula in Dogs

Chronically runny nose, with or without bleeding, and persistent sneezing are possible signs of this condition.

Diagnosis of Oronasal Fistula in Dogs

In most cases the space is so narrow that it can only be found by inserting a probe alongside the tooth root. Oronasal fistula is an unusual dental problem in the sense that x-rays often are not helpful in the diagnosis.
A thorough history of the dog's health is needed, onset of symptoms, and possible incidents that might have precipitated/preceded this condition. Veterinarian should perform a thorough physical and oral exam using a periodontal probe to investigate the suspected oronasal fistula. Also a complete blood profile will be conducted, including a chemical blood profile, a complete blood count, a urinalysis, and an electrolyte panel. The blood-work should be performed before anesthetizing the dog for surgical correction of the fistula.

Causes of Oronasal Fistula in Dogs

Oronasal fistulas are more common than oroantral fistulas in my experience. These lesions often appear as complications associated with dental extractions. To avoid these complications, all extraction sites should be closed using a well-designed mucogingival flap. These flaps need to be designed with maximal blood supply, epithelium- free edges and of adequate size to cover the underlying defect. The flaps should be sutured in a tension-free manner and preferably overlying bone. I prefer 4-0 Monocryl suture; however many suitable suture materials are available.

Periodontal disease is also a very common cause for oronasal or oroantral fistulas. Dachshunds are frequently affected. In these cases, deep palatal pockets (vertical bone loss) are often probed adjacent to the palatal aspect of the upper canine teeth. To avoid the development of these lesions, early recognition and appropriate periodontal therapy is required.

Other causes for communications between the oral cavity and the respiratory tract include foreign-body penetration, bite wounds and neoplasia. Inherited or developmental clefts of the lip or palate are also well-recognized causes of these defects. Each case must be precisely diagnosed and treated appropriately.

All in all possible causes may include :
  • Trauma
  • Bite wounds
  • Periodontal disease
  • Oral cancer
  • Electrical shock
  • Traumatic tooth extraction
  • Mandibular canines (the fang-like teeth) positioned toward the tongue
  • Upper jaw overbites, which causes the canine teeth in the bottom jaw to pierce the hard palate (roof of the mouth).

Treatment of Oronasal Fistula in Dogs

The only effective treatment would be surgical removal of the tooth, and closure of the passageway.
A skin flap will be placed in both the mouth and in the nasal cavity during closure. The size of the defect does matter. The appearance of the soft tissue lesion is typically much smaller than the underlying bony defect. Flap design must be based on the location and the size of the defect. Mucogingival flaps can be single or double layered. The single layer flap is useful in many cases, however the double flap repair can be particularly useful for chronic defects. Mucogingival flaps must be designed to allow maximal blood supply (tissue perfusion). They must be of sufficient length and width (1.5 to 2 times the defect size) to be tension-free. The connective tissue of the flap must be opposed to connective tissue of the defect. The edges of the defect and the flap should be debrided free of granulation tissue and epithelium. Ideally, the flap should be sutured over healthy bone. The incidence of flap dehiscence is greatly reduced by following these principles; maximum perfusion, overlying bone and tension-free. Flap dehiscence is also minimized by evaluating for, and eliminating occlusal trauma. Clients should withhold hard food and chew toys from the patient for two weeks following surgery, and avoid manipulating the mouth when administering oral medications.

Prognosis of Oronasal Fistula in Dogs

There is a high success rate for surgical closure of an oronasal fistula (success rate is about 90%).

Prevention of Oronasal Fistula in Dogs

Prevention of Oronasal Fistula is almost prevention the same as prevention of periodontal disease. Plus the owner should be careful about oral trauma and breeds like Dachshund.

Home Care of Oronasal Fistula in Dogs

Since a flap to repair an oronasal fistula undergoes constant tension each time the dog breathes, this fistulae tend to reopen. Additional surgeries with advanced tissue flaps can be performed if this occurs.

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Source :
- Image by : Animal Dentistry & Oral Surgery Specialists LLC (mypetsdentist.com).
- Some content taken from PetMD.com
- Some parts are re-written from dvm360.com

Oronasal and Oronatal Fistula in Dogs , Symptoms , Diagnosis and Treatment

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