Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study
The objective of this retrospective pilot study was to describe potential risk factors for failure of hard palate mucoperiosteal flaps (HPF) transposed for closure of oronasal communication. Dogs (n = 28) with acquired oronasal communication defects were included in the study population. Functional...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Veterinary Science |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fvets.2021.762842/full |
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| author | Kendall Taney Mark M. Smith Nathan P. Cummings Alicia J. Lozano |
| author_facet | Kendall Taney Mark M. Smith Nathan P. Cummings Alicia J. Lozano |
| author_sort | Kendall Taney |
| collection | DOAJ |
| description | The objective of this retrospective pilot study was to describe potential risk factors for failure of hard palate mucoperiosteal flaps (HPF) transposed for closure of oronasal communication. Dogs (n = 28) with acquired oronasal communication defects were included in the study population. Functional success of an HPF was determined by visual inspection at the last examination and lack of clinical signs. Risk factors for HPF failure including age, sex, body weight, presence of neoplasia at the time of surgery, presence of neoplasia after surgery due to incomplete or narrow margins, use of CO2 laser, previous surgeries in the same location, HPF blood supply, size of the HPF as a percentage of the total area of the hard palate mucoperiosteum, and distance traveled by the apex of the HPF were evaluated using descriptive statistics and unadjusted logistic regression modeling. Seven out of 28 (25%) hard palate flap procedures resulted in persistent oronasal communication and were considered failures. Body weight (Median: 17 vs. 25 kg, OR = 0.94, 80% CI = 0.90, 0.99), presence of neoplasia at the time of surgery (86 vs. 57%, OR = 4.50, 80% CI = 1.01, 20.06), HPF area (Median: 0.49 vs. 0.41, OR = 84.40, 80% CI = 1.66, 4,298) and apex travel distance (Median: 2.06 vs. 0.67, OR = 5.15, 80% CI = 2.14, 12.38) were associated with flap failure. Within this sample, the presence of neoplasia at the time of initial surgery, increasing the area of the HPF, and distance traveled by the HPF apex were associated with a greater odds of HPF failure. Further studies with larger sample sizes are needed to confirm repeatability of these results. HPFs remain a viable surgical option for closure of oronasal communication. Careful surgical planning, strict adherence to surgical principles, and awareness of anatomical limitations can increase the likelihood of success. |
| first_indexed | 2024-12-20T06:11:56Z |
| format | Article |
| id | doaj.art-545d104b5738478f9ea6ae4363c7ca72 |
| institution | Directory Open Access Journal |
| issn | 2297-1769 |
| language | English |
| last_indexed | 2024-12-20T06:11:56Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Veterinary Science |
| spelling | doaj.art-545d104b5738478f9ea6ae4363c7ca722022-12-21T19:50:39ZengFrontiers Media S.A.Frontiers in Veterinary Science2297-17692021-11-01810.3389/fvets.2021.762842762842Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot StudyKendall Taney0Mark M. Smith1Nathan P. Cummings2Alicia J. Lozano3Center for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD, United StatesCenter for Veterinary Dentistry and Oral Surgery, Gaithersburg, MD, United StatesMaxtena, Inc., Rockville, MD, United StatesCenter for Biostatistics and Health Data Science, Department of Statistics, Virginia Tech, Roanoke, VA, United StatesThe objective of this retrospective pilot study was to describe potential risk factors for failure of hard palate mucoperiosteal flaps (HPF) transposed for closure of oronasal communication. Dogs (n = 28) with acquired oronasal communication defects were included in the study population. Functional success of an HPF was determined by visual inspection at the last examination and lack of clinical signs. Risk factors for HPF failure including age, sex, body weight, presence of neoplasia at the time of surgery, presence of neoplasia after surgery due to incomplete or narrow margins, use of CO2 laser, previous surgeries in the same location, HPF blood supply, size of the HPF as a percentage of the total area of the hard palate mucoperiosteum, and distance traveled by the apex of the HPF were evaluated using descriptive statistics and unadjusted logistic regression modeling. Seven out of 28 (25%) hard palate flap procedures resulted in persistent oronasal communication and were considered failures. Body weight (Median: 17 vs. 25 kg, OR = 0.94, 80% CI = 0.90, 0.99), presence of neoplasia at the time of surgery (86 vs. 57%, OR = 4.50, 80% CI = 1.01, 20.06), HPF area (Median: 0.49 vs. 0.41, OR = 84.40, 80% CI = 1.66, 4,298) and apex travel distance (Median: 2.06 vs. 0.67, OR = 5.15, 80% CI = 2.14, 12.38) were associated with flap failure. Within this sample, the presence of neoplasia at the time of initial surgery, increasing the area of the HPF, and distance traveled by the HPF apex were associated with a greater odds of HPF failure. Further studies with larger sample sizes are needed to confirm repeatability of these results. HPFs remain a viable surgical option for closure of oronasal communication. Careful surgical planning, strict adherence to surgical principles, and awareness of anatomical limitations can increase the likelihood of success.https://www.frontiersin.org/articles/10.3389/fvets.2021.762842/fullpalateoralmaxillofacialflapsurgeryoncology |
| spellingShingle | Kendall Taney Mark M. Smith Nathan P. Cummings Alicia J. Lozano Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study Frontiers in Veterinary Science palate oral maxillofacial flap surgery oncology |
| title | Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study |
| title_full | Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study |
| title_fullStr | Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study |
| title_full_unstemmed | Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study |
| title_short | Risk Factors for Failure of Hard Palate Mucoperiosteal Flap Repair of Acquired Oronasal Communication in Dogs: A Pilot Study |
| title_sort | risk factors for failure of hard palate mucoperiosteal flap repair of acquired oronasal communication in dogs a pilot study |
| topic | palate oral maxillofacial flap surgery oncology |
| url | https://www.frontiersin.org/articles/10.3389/fvets.2021.762842/full |
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