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50 Cards in this Set

  • Front
  • Back
What is the most common congenital defect of the lips?
Cleft lip (harelip)
What causes a cleft lip?
Defect of the primary palate
(soft & hard palate= secondary palate)
What is the easiest approach to repairing a traumatic or iatrogenic defect on the lip?
Slice a piece out like a pie and suture together
You have a tumor that requires removal of the entire lip, what is your surgical approach?
Remove entire cheek and use a skin graft
What is the function of lips? (2)
1) To keep food and water in mouth while chewing
2) helps maintain better hygiene in mouth
What is the downfall to leaving a defect in the lips?
-Much messier when they eat and have water and food coming out of the mouth
-teeth accumulate tartar at a faster rate (why reconstruction is important)
What are 3 examples of indications for surgery on the tongue?
1) Laceration
2) Electrical trauma
-puppies
3) Neoplasia
What is generally done to repair lacerations on the tongue?
Suture them
What is generally done when there's necrosis or neoplastic lesions on the tongue?
A glossectomy
-historically can remove up to 75% of tongue
-newer studies show can do total glossectomy in DOG
Tongues are really important for dogs to lap water, so how can we perform a total glossectomy?
Learn to suck in the water
Why don't we perform total glossectomies on a cat?
Because grooming is a big part of their lifestyle and when you remove their tongue they are obtund & important for prehension
What structure do you want to try and preserve when performing a glossectomy?
Lingual artery
What are 2 indications for mandibular or maxillary surgery?
-Fractures-repair
-Neoplasia- excision
What is the most common malignant tumor in the oral cavity of cats?
Squamous cell carcinoma- by far
What are the top 4 most common malignant neoplasia of the oral cavity in dogs?
1) Squamous cell carcinoma
2) Fibrosarcoma
3) Malignant melanoma
4) Osteosarcoma
What are the 2 most common malignant neoplasia of the oral cavity in cats?
1) Squamous cell carcinoma*********
2) Fibrosarcoma
What are the 5 types of maxillectomies that can be performed?
1) Complete maxillectomy
-unilateral
2) Rostral maxillectomy on one side
3) Bilateral rostral maxillectomy, often called premaxillectomy bc technically its the incisive bone
4) Caudal maxillectomy
5) Ventral orbiectomy
-Caudal maxillectomy that goes up higher to the orbit
What do you have to reconstruct when performing a MAXILLECTOMY?
Communication bw the oral and nasal cavities is created so this must be reconstructed so food and water doesn't come out the nose
What do you need to make sure to do to lips when performing a maxillectomy?
when reconstruct the lip need to reconstruct mucosal site and skin site- can leave little defects in either one but too much of a defect then body may have a hard time healing it and contracts and can pull lip up and get malclosure of lip
-take lip and pull it in to reconstruct the two cavities
What is the primary issue with premaxillectomies?
lose support to nose and nose will drop. Can use techniques to bring nose up again but doesn't work very well so nose will look weird.
What is the prognosis of a maxillectomy?
Very dependent on tumor type
-function is good to excellent in dogs, less predictable in cats
-cosmetic depends on type
What are the 6 types of mandibulectomies that can be performed?
1) Unilateral rostral
2) Bilateral rostral
3) Segmental
4) Ramove ramus
5) Hemimandibulectomy
6) Hemimandibulectomy and part of the other
Why are complications with a mandibulectomy typically less severe than a maxillectomy?
severe b/c w/ maxilla if have a dehiscence then create a fistula b/w nose and mouth (oronasal fistula) and this happens in about 1/3 of cases. but with mandible there's less dehiscence bc don't have food hitting palate all the time, and not as big of deal bc food doesn't go into nose, just sits there
What is the prognosis of a mandibulectomy?
Very dependent on tumor type
How good is function in dogs and cats after a mandibulectomy?
Good to excellent in dogs
Less predictable in cats
What can cause swelling of the lip after a complete hemimandibulectomy?
Pseudorenulae
-just swelling of mucosa under tongue
What are the 2 etiologies of a palatal defect?
1) Congenital
2) Traumatic/ iatrogenic
-electrical
-foreign body
-tumor excision
What are 2 clinical signs of a palatal defect?
1) Nasal discharge
2) Sneezing
When do cleft palates usually become apparent?
When animal starts eating solid food because milk sucks down straight to the pharynx, but when start eating food goes up the nose
At what age should a surgical correction of a cleft palate be performed?
Delay surgery until ~16 weeks of age
-feeding tube can be placed in the mean time
What type of closure do you want to use for a cleft palate?
Try to achieve a Double layer closure
-try to avoid putting suture lines right over the defect
Why should you try to avoid putting the suture line right over the primary defect?
Because that's where the most tension is
-want to avoid tension on suture lines
Why is it important to minimize the use of cautery for cleft palate repair?
Has been shown to increase likelihood of dehiscence
What do you need to warn owners about when preparing to perform a cleft palate repair?
It may require several surgeries to repair large defects
What are 2 reasons to wait until 16 weeks of age to repair a cleft palate?
1) Greater chance of dehiscence bc animal is growing
2) Can get facial deformities because sutures make it so the bones cannot grow normally since they're restricted
-maybe wait longer on large/giant breeds since grow longer
What is the most common indication for surgery on a salivary gland?
A salivary mucocele (also known as a sialocele)
What is the typical clinical presentation of a dog with a salivary mucocele?
Swelling in the cervical, pharyngeal or sublingual (ranula) areas
What causes a salivary mucocele?
Caused by a leak in a salivary gland and/or duct
-most often idiopathic
How do you diagnose a mucocele?
Aspirate it and will see saliva
What is a ranula? What causes it?
Swelling under the tongue
-because there's saliva leaking out of the sublingual gland under the tongue and causing swelling.
What is the treatment for a salivary mucocele?
Remove the salivary gland and duct that are leaking
-also drain the saliva that has accumulated subcutaneously
What do you need to determine before surgically correcting a cervical mucocele?
Important to know what side is leaking because due to gravity fluid tends to accumulate in the middle
What are 2 ways to determine what side a cervical mucocele is really on?
1) History, some owners will know where it started
2) Put in dorsal recumbency and swelling will fall to the side that its coming from
Do you have to worry about xerostomia when performing a bilateral salivary gland removal?
No, there's enough other glands to compensate
Which salivary gland has a monostomatic and polystomatic gland?
Sublingual
What are the 4 salivary glands?
1) Parotid
2) mandibular
3) Sublingual
-monostomatic & polystomatic
4) zygomatic
What technique is used to repair a ranula or pharyngeal mucocele?
Marsupialization: don't remove salivary gland. Go at base of tongue and cut out the swelling and suture the mucosa but bc haven't removed salivary gland itself it leaks but now leaks into mouth. This allows saliva that used to be accumulating in submucosa to now leak into mouth
What is the most common indication for a tonsillectomy?
Neoplasia (still rarely a problem)
What are the 2 most common types of neoplasia that affect the tonsils?
1) Lymphoma (does not require surgery, going to need chemotherapy)
2) Squamous cell carcinoma
When should you ALWAYS perform a bilateral tonsillectomy?
When a tonsil has a squamous cell carcinoma