Article: Volume 46 Number 9 Page 825 - October 2019

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  Dent Update 2019; 46: 825-826

Maxillofacial Surgery:  An Unusual Presentation of Oro-Naso-Palatal Fistula

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Abstract: This case report is of a 29-year-old male who complained of nasal escape of food and fluids through his nose for 6 months. Further questioning revealed a previous cocaine habit which has now ceased. Examination revealed a septal perforation and CT scanning revealed a 16 mm wide sagittal bone defect involving most of the hard palate as well as absence of the inferior half of the nasal septum. A diagnosis of septal perforation leading to an oro-naso-palatal fistula was made. This rather unusual presentation and clinical findings are discussed within this article.

Clinical relevance: The effects of cocaine misuse on the oral mucosa are presented.

Author notes: Ammar Hamid, BDS(Hons) (email: and Priyanka Patel, BDS(Hons), MFDS RCS(Glasg), Department of Oral and Maxillofacial Surgery, Whipps Cross University Hospital, London, UK.

Objective: To describe the effects of cocaine misuse and highlight management options for an oro-nasal-palatal fistula, including provision of an upper acrylic cover plate fabricated by the patient’s GDP.


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