Traumatic Palatal Defects in Cats
Traumatic palatal defects are relatively common in cats and are often associated with maxillary fractures resulting from road traffic accidents and can be a component of “high rise syndrome”.
Whiskey had been involved in a road traffic accident that had eventually resulted in widespread fibrosis of his masticatory muscles and an inability to open his mouth. The referring vet performed a bilateral rostral mandibulectomy so that Whiskey could lap food. This was successful and Whiskey was able to eat well enough to maintain his body weight. However he eventually developed an oronasal fistula in the caudal right hard palate and a subsequent chronic rhinitis. It is likely that the fistula was due to ongoing abrasion of the palatal mucosa with the tongue because of his inability to open his mouth and underlying palatal bone defects associated with the original maxillary fractures.
Conventional techniques to repair the fistula were not suitable for this case because surgical access was very limited and repeated abrasion of the surgical site would have predisposed to wound breakdown.
The use of palatal obturators is a recognised technique to temporarily close traumatic palatal defects whilst tissues heal prior to definitive surgical closure. They are also used as a long term solutions in some cases where surgery is not possible or has failed. In Whiskey’s case a silicone nasal septal button (Invotec International, Florida, USA) was used as a semi permanent obturator. Whiskey tolerated the obturator very well and his nasal discharge quickly resolved.
The button is still in place and well tolerated twelve months after initial placement.