犬口鼻瘘修复中倒置腭黏骨膜瓣经骨缝线固定于残留颊侧牙槽骨

文献信息

中文摘要

背景： 晚期牙周病可损害口鼻瘘修复时用于瓣固定的受区组织。本报告描述了一只8岁去势雄性比格犬获得性牙周性口鼻瘘的双层修复。方法：X线片和计算机断层扫描（CT）识别出缺损邻近区域的区域性骨丧失和残留牙槽骨。在拔除左侧上颌犬齿和第二前磨牙并清创瘘边缘后，将倒置的硬腭黏骨膜瓣通过18号针头创建的四个经骨骨孔锚定于残留颊侧牙槽骨。经骨缝线固定使用4-0聚二氧环己酮简单间断缝线。颊黏膜推进瓣覆盖倒置瓣和腭部供区；未使用插入性移植物。结果：术后第18天记录到无临床明显裂开的愈合，鼻分泌物至第45天已消退。第555天时，口腔目视检查显示修复完整，并因无关的耳科指征获得的CT结果一致。结论：本病例说明，当牙周组织丧失限制牙龈受区边缘时，可利用残留颊侧牙槽骨进行腭瓣附着，并在晚期临床和影像学再评估中记录到闭合维持。

英文摘要

Advanced periodontal disease can compromise the recipient tissues available for flap fixation during oronasal fistula repair. This report describes double-layer repair of an acquired periodontal oronasal fistula in an eight-year-old castrated male Beagle. Radiographs and computed tomography (CT) identified regional bone loss and residual alveolar bone adjacent to the defect. Following extraction of the left maxillary canine and second premolar and debridement of the fistula margins, an inverted hard palatal mucoperiosteal flap was anchored to residual buccal alveolar bone through four transosseous bone holes created with an 18-gauge needle. Transosseous suture fixation used 4-0 polydioxanone simple interrupted sutures. A buccal mucosal advancement flap covered the inverted flap and palatal donor site; no interpositional graft was used. Healing without clinically evident dehiscence was documented on postoperative day 18, and nasal discharge had resolved by day 45. At 555 days, visual oral examination revealed an intact repair, with concordant CT findings obtained for an unrelated otologic indication. This case illustrates the use of residual buccal alveolar bone for palatal flap attachment when periodontal tissue loss limits gingival recipient margins, with maintained closure documented at late clinical and imaging reassessment.