Levator labii superioris muscle transposition to treat oromaxillary sinus fistula in three horses.

Summary

# Editorial Summary: Surgical Management of Oromaxillary Sinus Fistulae via Muscle Transposition Chronic oromaxillary sinus fistulae—abnormal communications between the maxillary sinus and oral cavity typically arising from molar tooth loss—present a challenging surgical problem in equine practice, as traditional closure methods often fail to achieve durable healing. Brink's 2006 case series describes an innovative approach using transposition of the levator labii superioris muscle: the muscle belly was severed from its tendinous insertion, retracted through the fistula defect, and re-anchored via a new subcutaneous tunnel that directed the tendon ventrally through a buccal incision adjacent to the fistula opening. All three horses achieved fistula closure with minimal complications and acceptable cosmetic and functional outcomes, suggesting that this technique offers a viable alternative when conventional repair has proven ineffective. For practitioners managing horses with refractory oromaxillary sinus fistulae, this muscle transposition method warrants consideration as part of the surgical toolkit, particularly when other closure strategies have been exhausted, though the limited case series size means further validation would strengthen confidence in its broader application.

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Key Findings

• •Levator labii superioris muscle transposition successfully treated oromaxillary sinus fistulas in all 3 horses
• •Fistulae healed with few complications and good cosmetic and functional results
• •Procedure involves severing muscle insertion, transposing muscle through fistula, and anchoring tendon to cheek tissues

Conditions Studied