ORONASAL FISTULA SECONDARY TO TRAUMA –A RARE CLINICAL IMAGE

Sahana K., Raghavendra Kini, Kamakshi Jha and Shwetha Kajjari

ABSTRACT

A 45 yrs old male patient has visited out patient department with the chief complaint of nasal regurgitation of food since 8 months. He had met with the accident 8 months back, following which he developed nasal regurgitation. Voice with the nasal twang was present. Patient was using denture adhesive gel to cover the palatal defect. On intra oral examination, an oval defect measuring 0.5x 1cm, on the left side of mid palatine raphe in the hard palate communicating with the floor of the nasal cavity was evident.Water in mouth test was positive with nasal regurgitation of water. The soft tissue surrounding the perforation was normal. Based on history and clinical examination provisional diagnosis of oronasal fistula of posterior hard palate was considered. The oronasal fistula is the condition in which a chronic communication between the oral and nasal cavity occurs. It usually affects the patients with cleft palate. However, other uncommon etiologies of oronasal fistula are facial traumas, infections and neoplasia.[1] In present a case of oronasal fistula was present as a consequence of facial trauma. According to Smith et al. palatal fistula can be divided into seven types: Type I—referred to bifid uvula. Type II—means fistula in the soft palate. Type III—means fistula at junction of the soft and hard palates. Type IV—means fistula in the hard palate. Type V—indicates that the fistula at junction of the primary and secondary palates. Type VI—means lingual alveolar fistula. Type VII—means labial alveolar fistula.[2] Our case comes under type 4 subdivision.

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