In the image of a male neutered 5-year old Dachshund, what is unusual about the tissue identified during an oronasal fistula repair?

A purple discoloration of the mucosa and gingiva can be seen adjacent the green examination glove.

Perforation and trauma of the oral mucosa/gingiva occurred during elevation of the mucoperiosteal flap for repair. What does the discoloration likely indicate? The blood supply to the tissue (mucoperiosteal flap) is compromised. Therefore the suboptimal tissue should not be used to close the to oronasal defect.

Question:

What is a surgical option in this case?

• Answer:

  

  The incision was extended distal to the region of the right maxillary fourth premolar (108) to prepare for the excision of the compromised gingiva, which was subsequently excised.  The final excision of compromised tissue was delayed until the flap was created in order to ensure an appropriate sized mucoperiosteal flap was elevated to close the defect without tension.

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  This image shows closure of the oronasal defect without tension.