Bilateral overlapping mucosal single-pedicle flaps for correction of soft palate defects

The clinical outcomes of bilateral overlapping single-pedicle flaps used for repair of congenital cleft of the soft palate in 10 animals (nine dogs and one cat) are reported. Six animals had concurrent cleft of the hard palate repaired using a previously described mucoperiosteal flap technique. Animals ranged from one to 13 months of age at surgery, with follow-up ranging from two to 12 months. Healing was uncomplicated in all cases and provided excellent functional results.     

Successful engraftment of cultured autologous mesenchymal stem cells in a surgically repaired soft palate defect in an adult horse

The objective of this study was to graft autologous mesenchymal stem cells (MSCs) at the site of surgical repair of a soft palate defect in an adult horse in an attempt to improve wound healing and to investigate whether the transplanted MSCs would integrate into the soft palate structure and participate in regeneration. Bone marrow was collected from an adult horse with a full-thickness soft palate defect. The MSCs were isolated, cultured in monolayers, and labeled with 5-bromo-2-desoxymidine (BrdU) and chloromethylbenzamido-DiI-derived (cm-DiI) before transplantation. The soft palate defect was repaired by mandibular symphysiotomy, and the labeled MSCs were injected into the repaired soft palate. Postmortem examination revealed that 90% of the soft palate defect had been sutured. Staining by BrdU and cm-DiI was intense in the soft palate tissue. Labeled MSCs were detected in tissue slices from the injection sites. The cells were organized in a manner similar to that in native soft palate tissue, indicating successful engraftment.     

Cleft Palate in a Chinchilla (Chinchilla lanigera)

A 5-month-old female chinchilla (Chinchilla lanigera) was evaluated for failure to thrive, difficulty drinking, and respiratory signs. Physical examination demonstrated a thin body condition score, purulent nasal and ocular discharge, and an abnormal facial appearance. Endoscope-guided oral examination and computed tomography (CT) scan demonstrated a cleft soft palate, absent nasal turbinates, and bilateral otitis media. The animal was euthanized and necropsy confirmed the diagnosis of palatoschisis (cleft palate) of the soft palate. Other relevant postmortem findings included otitis media, interna, and externa, bony bullae proliferative changes, absent nasal turbinates and rhinosinusitis. Congenital abnormalities are rarely reported in chinchillas. While cleft palates have been reported in many other domestic animals, there are no published reports of this condition in chinchillas to the best of the authors’ knowledge.     

Surgical repair of cleft soft palate in the horse.

A technique for the surgical repair of a cleft soft palate in the horse is described. A symphysiotomy approach was employed to repair the anterior end of the cleft palate, and the posterior part was approached via a pharyingotomy incision.     

Clinical characteristics of horses and foals diagnosed with cleft palate in a referral population: 28 cases (1988–2011)

The objective of this case series was to characterize the population, case presentations, and outcomes of 28 equids diagnosed with cleft palate over a 25-year period. The incidence of cleft palate was 0.04%. The median age at presentation was 2 mo (range: 1 d to 3 y). Fifty percent of the animals were < 2 mo old, 21% were ≥ 2 mo but < 1 y old, and 29% were 1 y of age or older. Males and females were nearly equally represented. Short-term outcomes included euthanasia in 50%, surgical repair in 11%, supportive care in 4%, and no treatment in 32% of cases; 46% of the animals survived to discharge. Defects involving both the hard and soft palate and/or aspiration pneumonia generally had less favorable outcomes. Though cleft palate is rare in horses, it should be considered as a differential diagnosis in horses of all ages with nasal discharge, a cough, a history of recurrent respiratory infections, poor growth, or chronic submandibular lymphadenopathy. Endoscopic evaluation of the pharynx may aid in earlier diagnosis and prognostication for owners.     

Otitis media in five cats associated with soft palate abnormalities

The medical records of five cats that were diagnosed with otitis media and soft palate abnormalities, three of which had concurrent otitis interna, were reviewed retrospectively. The animals presented with unilateral or bilateral otitis media or otitis interna associated with soft palate hypoplasia (four cases) or unilateral soft palate cleft (one case). Otitis media was confirmed by radiography, CT or MRI. The soft palate abnormalities present were discovered on oropharyngeal examination at induction of anaesthesia. These five cases provide additional support of a link between otitis media and soft palate abnormalities in cats, as reported in humans and dogs.     

Surgical repair of a cleft soft palate in an alpaca

A 26-day-old entire male alpaca was referred for surgical treatment of a cleft soft palate. Mandibular symphysiotomy and three-layer closure of the palatal defect resulted in primary intention healing. Despite complications related to anaesthesia the alpaca made a full recovery.     

Histology of Palate and Soft Palate Tonsil of Collared Peccary (Tayassu tajacu)

Peccaries are characterized by a prominent skin gland, known as scent gland, which is located in the middle of the rump. These animals are able to survive in a great variety of habitats, from humid tropical forests to semi‐arid areas. They are omnivorous animals, and their diet includes fibrous material, vegetables, fruits, small vertebrates and insects. Collared peccary hard palate and soft palate tonsils were studied, macroscopic morphometric data were collected and tissue samples were paraffin‐embedded. Sections were stained with HE, Gomori′s trichrome and von Kossa; the first two were used to study general organization and the latter to detect calcium deposits. The hard palate showed one incisive papilla followed by several rugae united by a distinct raphe. The hard palate is lined by a keratinised squamous epithelium resting on a dense connective, whereas in the soft palate, the epithelium is parakeratinised and showed lymphocyte infiltration. The palate showed several pacinian corpuscles in the propria‐submucosa. Two ovoid‐shaped tonsils were found in the soft palate, and several crypts were observed on its surface. The epithelium was highly infiltrated by lymphocytes, and within the crypts, tonsilloliths were frequently observed. The study showed that the general organization of collared peccary palate is similar to other species, but in its oropharynx, only the soft palate tonsil was present and the pacinian corpuscles formed small aggregates.     

Application of a temporary palatal prosthesis in a puppy suffering from cleft palate

A 3-month-old Schnauzer was presented with congenital defects of the secondary palate. On the clinical examination, coughing, sneezing, drainage of nasal discharge from the external nares and poor growth were found. Vital signs and results of blood examination were within normal ranges. Thoracic radiography revealed mild pneumonia in the right lung lobes. In a puppy suffering from cleft palates, a palatal prosthesis was applied to the hard palate in order to protect the surgical wound, because a routine surgery was not successful. A palatal prosthesis was applied and held in place using the instant glue and plastic bands to protect the surgical wound following the third repeated surgery. Although a small oronasal fistula still remained, there was no functional defect. This prosthesis was easy to apply and helpful to protect the surgical wound. In addition, this implant could be placed or adjusted without or sedation/anesthesia.     

Orofacial manifestations of high-rise syndrome in cats: a retrospective study of 84 cases

Medical records of cats with high-rise trauma were reviewed to document the prevalence and clinical manifestations of orofacial injury. Cats were presented over a 10-year period from January 2000 to December 2009. Signalment, weight, number of stories fallen, and survival data were recorded in 84 cats and physical examination findings were obtained from 83 cats. Fourteen of these cats were examined by veterinarians of the Dentistry and Oral Surgery Service. Mean age was 37-months. Mean distance fallen was 2.65 stories, and in the majority of cases the substrate the cat fell on was not recorded Overall, survival was 94.0% when including euthanasia as a cause of death and 98.8% when excluding euthanized patients. Orofacial findings included bilateral epistaxis, hard palate fracture +/- tear of palatal soft tissue, palatal soft tissue bruising, mandibular fracture, mandibular symphyseal separation, tongue injury, facial soft tissue injury, dental trauma, and other oral soft tissue injury. Sixty-six percent of cats suffered some degree of orofacial injury. The population was analyzed for the prevalence of each type of injury. An oronasal fistula was seen in one cat as a complication of an untreated hard palate fracture. Possible etiology of the injuries and treatment options are discussed.     

Free tissue transfer of the rectus abdominis myoperitoneal flap for oral reconstruction in a dog

A five-month-old intact/male Boxer dog was presented 5-days following bite wound trauma to the maxillary region resulting in an oronasal fistula extending from the maxillary canine teeth to the soft palate. Multiple surgical procedures using local, buccal mucosal flaps failed to repair the oronasal fistula. Free tissue transfer of the rectus abdominis myoperitoneal flap using microvascular surgical techniques was successful in providing soft tissue reconstruction of the hard palate area. Complications of these surgical techniques included muscle contraction and subsequent muzzle distortion. Small, refractory oronasal fistulae at the perimeter of the myoperitoneal flap were repaired by primary wound closure.     

ULTRASONOGRAPHIC ASSESSMENT OF LARYNGOHYOID POSITION AS A PREDICTOR OF DORSAL DISPLACEMENT OF THE SOFT PALATE IN HORSES

Dorsal displacement of the soft palate is an important cause of poor performance in racehorses, yet its etiology is not fully understood. Diagnosis requires treadmill videoendoscopy, which is not widely available. The relationship of the larynx, the hyoid apparatus, and the remainder of the skull may be important in predisposing horses to dorsal displacement of the soft palate. We hypothesized that this relationship could be accurately assessed in unsedated horses through ultrasonographic examination. Fifty-six racehorses presented for evaluation of poor performance were subjected to treadmill videoendoscopy and resting ultrasonography. Using ultrasound-assisted percutaneous measures of laryngo-hyoid position, the relationship between selected anatomic structures and the occurrence of dorsal displacement of the soft palate was evaluated. A significant relationship was found between the depth of the basihyoid bone at rest and the occurrence of dorsal displacement of the soft palate at exercise ( P =0.03). Other measures of laryngohyoid position were not found to be associated with dorsal displacement of the soft palate. Thus, there is an association between the occurrence of dorsal displacement of the soft palate at exercise and the resting position of the basihyoid bone, whereby on average a more ventral location of the basihyoid bone is present in horses with dorsal displacement of the soft palate. The pathophysiologic implications of this finding are not fully understood but, based on our findings, ultrasound examination is of value in assisting in the diagnosis of dorsal displacement of the soft palate.     

Use of local and axial pattern flaps for reconstruction of the hard and soft palate

There are numerous conditions that may result in defects of the hard and soft palate. Reconstruction of these defects may be difficult due to anatomical limitations and limited tissue availability. The majority of palate defects, even when large, may be closed using local and/or axial pattern flaps, while other more advanced techniques such as free tissue transfer and prosthetic implants are required in a smaller number of cases. This article describes the use of local and axial pattern flaps in the reconstruction of the hard and soft palate.     

Repair of a gingival cleft associated with a maxillary canine tooth in a dog

This case report describes repair of a gingival cleft located on the labial aspect of the maxillary left canine tooth in a client-owned dog. Multiple procedures were performed including elevation of a pedicle flap, granulation tissue removal, alveoloplasty and root planing, and placement of an osteoconductive bone graft material. The surgical site was closed with a laterally repositioned flap. Postoperative examinations were performed at 2 and 3-weeks without chemical restraint and at 3 and 10-months postoperatively under general anesthesia. At the 10-month postoperative examination, a broad band of gingiva surrounded the maxillary left canine tooth, and probing revealed absence of periodontal pockets. Intraoral dental radiographs indicated maintenance of alveolar bone height and incorporation of the bone graft material into alveolar bone.     

Congenital unilateral cleft of the soft palate in six dogs

Unilateral cleft of the soft palate occurs sporadically in dogs, and there are few reports in the veterinary literature regarding its aetiology and management. This report describes six dogs with the condition. The dogs' primary presenting problem was rhinitis. The defects were successfully repaired using a two-layer closure technique with absorbable suture in five of the cases. Surgical correction was not performed in the remaining case.     

Palatal sclerotherapy: a potentially useful treatment of intermittent dorsal displacement of the soft palate in juvenile standardbred racehorses

This study was aimed at evaluating the tolerability and the efficacy of palatal sclerotherapy in juvenile standardbred racehorses with easily audible "snoring-like" respiratory noises suspected to be the result of intermittent dorsal displacement of the soft palate. The palate of 8 horses was injected with sodium tetradecyl sulfate under videoendoscopic guidance. Palatal sclerotherapy resulted in resolution of the respiratory noise in 7 horses, improvement of performance in 6 horses, and mild side effects in only 3 horses. This preliminary study suggests that palatal sclerotherapy is a safe, repeatable, inexpensive, and promising technique that should be considered as an alternative to existing treatments of intermittent dorsal displacement of the soft palate.     

A histopathological comparison of two techniques for soft palate resection in normal dogs

Eighteen dogs were used to compare histopathological findings following excision of the soft palate using either a bipolar sealing device or a carbon dioxide laser. Histopathological comparisons were done at 48 and 96 hours after soft palate resection. Mean depths of tissue injury at 96 hours were 3.5 and 3.33 mm for bipolar sealing device and carbon dioxide laser, respectively. Control of hemorrhage was excellent in all dogs, and none of the dogs developed signs of respiratory compromise after soft palate resection. Using the bipolar sealing device for soft palate resection was significantly faster than using the carbon dioxide laser, although both techniques were fast.     

Congenital narrowing of the intrapharyngeal opening in a dog with concurrent oesophageal hiatal hernia

A one-year-old, male, smooth-haired standard dachshund was presented with a history of chronic hypersalivation, dysphagia, puffing of the cheeks on expiration, and inspiratory stridor. Oral examination revealed a moderately thickened tongue radix and that the normal intrapharyngeal opening was obliterated. A 7 mm long, midline palatal slit was the only communication between the naso- and oropharynx. The soft palate was fused to the caudal pharyngeal wall. A concurrent hiatal hernia was diagnosed on thoracic radiographs. The soft palate abnormality was surgically corrected and the hiatal hernia was managed medically. On follow-up evaluations, the clinical signs had markedly improved, and the hiatal hernia was no longer visible on survey thoracic radiographs.