AN 11 year-old boy was referred to a pediatric otolaryngologist because of a history consistent with an oronasal fistula. He stated that he was able to chew melon and squirt it through his nose. He had no history of a cleft lip or palate. His primary care physician had been unable to locate a fistula. On careful examination by the otolaryngologist, an opening in the region of the incisive foramen was noted. It was located in the midline just posterior to his incisors. Using a fine-suction catheter, advancement of several millimeters led to the suspicion of a patent duct. A CT scan of the palate was obtained to confirm the fistula and to evaluate the remainder of bony palate (Figure 1, Figure 2, Figure 3, Figure 4, Figure 5, and Figure 6).
Winslow CP, Chan KH, Strain JD. Imaging Quiz Case 2. Arch Otolaryngol Head Neck Surg. 1998;124(11):1275-1278. doi:10-1001/pubs.Arch Otolaryngol. Head Neck Surg.-ISSN-0886-4470-124-11-ori7399