Small Animal Soft Tissue Surgery Q&A 01

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This dog was presented with an acute inability to close the mouth but no lateral deviation of the mandible.

Question	Answer		Article
What is your tentative clinical diagnosis?	Bilateral traumatic luxation of the temporomandibular joint.		[[|Link to Article]]
How can this diagnosis be confirmed?	The diagnosis is confirmed by radiography. Two views are currently in use: the dorsoventral closed-mouth skull radiograph and the closed-mouth lateral oblique view (15–20°, nose tilted up). Unilateral or bilateral luxation is radiologically evidenced by the fact that the condyloid process is not located within the mandibular fossa. Capsular osteophyte formation is evidence of a long-standing or recurrent luxation. Usually, the condyloid process displaces rostrodorsally. If unilateral, the animal is presented with a typical lateral deviation to the side opposite the luxated joint.		[[|Link to Article]]
Presuming that the tentative diagnosis is confirmed, what is the treatment?	Reduction is accomplished under general anesthesia by forcing the condyle ventrally. This can be done by inserting a fulcrum (e.g. pencil, syringe, dowel – depending on patient size) in between the molar teeth and gently forcing the mouth closed; this in turn levers the condyloid process in a ventrocaudal direction back into the condyloid fossa. Aftercare may include the use of a tape muzzle. Recurrent and chronic luxations can be treated by condylectomy.		[[|Link to Article]]