Cause unknown.  Long standing oronasal fistula affecting the hard palate of a dog.  Top left, initially a small flap to the right side, hinged at the defect and rolled inwards.  Top right, larger flap from the left side, hinged at the defect and rolled inwards, sutured to the first flap to complete the nasal closure.  A second rotational flap of buccal mucosa from inside the cheek on the right is then sutured over this to the edges of the defect as a second layer, bottom left.  At three weeks, healing is very good, with some partial thickness loss of the oral flap, bottom right.

First published Wed, Jun 29 2011