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Oro-Nasal Communication

Sahoo, Nanda Kishore MDS, FIBOMS; Desai, Ajay P. MDS; Roy, Indranil Deb MDS, FIBOMS; Kulkarni, Vishal BDS

doi: 10.1097/SCS.0000000000002815
Brief Clinical Studies
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Introduction: Breach in the palatal vault leading to an abnormal communication between oral and nasal cavity is known as oro-nasal communication. It is an uncommon presentation in day-to-day clinical practice except in some patients of cleft lip and palate.

Etiology may be congenital or acquired. Alveolar and palatal cleft defects are the most common etiological factor. The acquired causes may be trauma, periapical pathology, infections, neoplasms, postsurgical complications, and radio and chemo necrosis.

Clinical features like nasal regurgitation of food, defective speech, fetid odor, bad taste, and upper respiratory tract and ear infection are associated with oro-nasal communication.

Management depends upon the size and site of defect, age of patient, and associated comorbidity. The definitive management is always surgical. Two layered closure provides greater support and stability and reduces the risk of failure. Palatal rotational flaps are suitable for smaller defects. The other local flaps are buccal mucosal flap, tongue flap, and facial artery myomucosal flap. Temporoparietal galeal flap, turbinate flap, free radial forearm flap, and scapular flap have also been successfully used for closure of oronasal communication. Newer procedures like the use of bone morphogenic protein, acellular dermal matrices, human amniotic membrane, and distraction osteogenesis have been tried successfully. The rate of recurrence is high.

Unsuccessful surgical attempts and larger defects associated with compromised medical conditions are better managed nonsurgically with obturator incorporating the missing teeth.

Deptment of Oral and Maxillofacial Surgery, CMDC (WC), Chandimandir, Panchkula, Haryana, India.

Address correspondence and reprint requests to Dr Nanda Kishore Sahoo, MDS, FIBOMS, Prof and Head, Department of Oral and Maxillofacial Surgery, CMDC (WC), Chandimandir, Panchkula 134107, Haryana, India; E-mail: colnksahoo@gmail.com

Received 19 December, 2015

Revised 18 March, 2016

Accepted 25 March, 2016

The authors report no conflicts of interest.

© 2016 by Mutaz B. Habal, MD.