Difference between revisions of "Small Animal Soft Tissue Surgery Q&A 01"

From WikiVet English
Jump to navigation Jump to search
(Created page with "[[|centre|500px]] <br /> '''This dog was presented with an acute inability to close the mouth but no lateral deviation of the mandible.''' <br /> <FlashCard questions="3"> |q...")
 
 
(4 intermediate revisions by 3 users not shown)
Line 1: Line 1:
[[|centre|500px]]
+
{{Template:Manson
 +
|book = Small Animal Soft Tissue Surgery Q&A}}
 +
 
 +
 
 +
[[File:SmAn ST Sx 01.jpg|centre|500px]]
  
 
<br />
 
<br />
  
'''This dog was presented with an acute inability to close the mouth but no lateral deviation of the mandible.'''
+
'''A surgical procedure underway in the oral cavity of a four-month-old, male Bulldog is shown. The owner’s complaint is that the dog has a chronic mucopurulent nasal discharge, coughs when eating or drinking, and has not been gaining weight at a rate equal to that of his litter mates. He also has a foul odor from the oral cavity.'''
  
 
<br />
 
<br />
  
 
<FlashCard questions="3">
 
<FlashCard questions="3">
|q1=What is your tentative clinical diagnosis?
+
|q1=What is the diagnosis?
 
|a1=
 
|a1=
Bilateral traumatic luxation of the temporomandibular joint.
+
Congenital cleft of the hard and soft palates (secondary palatal defect).
|l1=
+
|l1=Cleft Palate
|q2=How can this diagnosis be confirmed?
+
|q2=What secondary complication may be associated with this defect?
 
|a2=
 
|a2=
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).
+
Aspiration pneumonia is often a complication of secondary palate defects. The animal should be evaluated with thoracic radiographs and treated appropriately prior to surgical correction of the palate defect.
 
+
|l2=Cleft Palate
Unilateral or bilateral luxation is radiologically evidenced by the fact that the condyloid process is not located within the mandibular fossa.
+
|q3=What are three principles to be followed during surgical repair of this problem?
 
 
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.
 
|l2=
 
|q3=Presuming that the tentative diagnosis is confirmed, what is the treatment?
 
 
|a3=
 
|a3=
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
+
Repair flaps should be larger than the primary defect to reduce tension on suture lines.  
levers the condyloid process in a ventrocaudal direction back into the condyloid fossa.
 
  
Aftercare may include the use of a tape muzzle.  
+
Connective tissue and vascular supply is preserved by limited meticulous dissection (avoid the palatine artery) and gentle tissue handling.  
  
Recurrent and chronic luxations can be treated by condylectomy.
+
Tissue flaps are apposed to cleanly incised epithelium to ensure healing.  
  
|l3=
+
Temporary feeding via a pharyngostomy or gastrostomy tube should be considered to bypass the oral cavity during wound healing.
 +
|l3=Cleft Palate#Treatment
 
</FlashCard>
 
</FlashCard>
  

Latest revision as of 12:09, 19 October 2011


Mansonlogo This question was provided by Manson Publishing as part of the OVAL Project. See more Small Animal Soft Tissue Surgery Q&A.





SmAn ST Sx 01.jpg


A surgical procedure underway in the oral cavity of a four-month-old, male Bulldog is shown. The owner’s complaint is that the dog has a chronic mucopurulent nasal discharge, coughs when eating or drinking, and has not been gaining weight at a rate equal to that of his litter mates. He also has a foul odor from the oral cavity.


Question Answer Article
What is the diagnosis? Link to Article
What secondary complication may be associated with this defect? Link to Article
What are three principles to be followed during surgical repair of this problem? Link to Article


Small Animal Soft Tissue Surgery Q&A 02Next Question.png