Repair of cleft palate in a calf using polypropylene mesh and palatal mucosal flap: a case report

Abstract

The soft palate plays a critical role in the oral and pharyngeal phases of swallowing. Congenitally cleft soft palates (palatoschisis) in calves are rare and pose a serious challenge for surgical correction due to high complication rates. The main obstacles to repairing palate defects are obtaining complicated access to the soft palate, and reducing the tension on the repair so that the sutures hold. A 21 day old female Simmental calf was submitted to our clinic with a history of frequent episodes of coughing and milk dripping from its nostrils after suckling. After clinical examination, a congenital cleft palate was diagnosed. Surgery was performed under general anaesthesia. First, lateral buccotomy was performed to improve the intraoral approach. The palatal defect was repaired using polypropylene mesh and palatal mucosal flap. An oesophageal tube was placed and anchored to the skin using a Chinese finger trap suture technique. Antibiotic treatment was continued through seven days and a transoesophageal feeding tube was fitted at the end of the surgery allowing the calf to be fed with milk during the postoperative period. Postoperatively, the caudal aspect of the repair broke down resulting in persistent mild bilateral nasal discharge. A combination of the two described techniques can be a good option for resolving palatal defects. However, adequate exposure and repair are still difficult to achieve and these approaches often result in serious postoperative complications.

Keywords

• cleft palate
• surgical treatment
• calf