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Questions and Answers
Questions and Answers
What is a critical consideration during oropharyngeal surgery to minimize complications?
What is a critical consideration during oropharyngeal surgery to minimize complications?
- Using any positioning technique, as long as it is convenient for the surgeon.
- Relying heavily on textbook anatomy without accounting for individual variation.
- Using dim lighting to reduce glare and improve focus.
- Avoiding damage to vital structures such as facial nerves and blood vessels. (correct)
During oropharyngeal surgery, it is acceptable to leave packing in the surgical site as long as it is well-secured.
During oropharyngeal surgery, it is acceptable to leave packing in the surgical site as long as it is well-secured.
False (B)
What specific type of suture pattern is preferred for appositional closure in oropharyngeal surgery?
What specific type of suture pattern is preferred for appositional closure in oropharyngeal surgery?
Simple interrupted or continuous
Applying direct pressure and using bipolar cautery are methods to achieve ______ during oral surgery.
Applying direct pressure and using bipolar cautery are methods to achieve ______ during oral surgery.
Match the following clinical signs with the oral disease they indicate.
Match the following clinical signs with the oral disease they indicate.
What is a key differential in the diagnosis of oral masses in dogs and cats?
What is a key differential in the diagnosis of oral masses in dogs and cats?
Fine needle aspiration (FNA) is generally considered the most rewarding method for obtaining cytology of primary oral masses.
Fine needle aspiration (FNA) is generally considered the most rewarding method for obtaining cytology of primary oral masses.
What is the primary goal of surgery for oral neoplasia beyond the cosmetic and functional outcome?
What is the primary goal of surgery for oral neoplasia beyond the cosmetic and functional outcome?
In the context of mandibulectomy, knowing how much ______ loss is present is critical to plan the surgical approach.
In the context of mandibulectomy, knowing how much ______ loss is present is critical to plan the surgical approach.
Match each type of oral surgical procedure with its description.
Match each type of oral surgical procedure with its description.
Why is total hemimandibulectomy associated with a high risk of haemorrhage?
Why is total hemimandibulectomy associated with a high risk of haemorrhage?
Maxillectomy is generally considered an easier procedure than mandibulectomy due to better accessibility and visibility.
Maxillectomy is generally considered an easier procedure than mandibulectomy due to better accessibility and visibility.
What are the four most common malignant oral tumors in dogs (in order)?
What are the four most common malignant oral tumors in dogs (in order)?
In cats, ________ is the most common oral tumour, accounting for over 70% of cases.
In cats, ________ is the most common oral tumour, accounting for over 70% of cases.
Match the TNM classification with the primary components of cancer staging.
Match the TNM classification with the primary components of cancer staging.
What is the primary diagnostic test of choice for identifying and characterizing oral masses for biopsy?
What is the primary diagnostic test of choice for identifying and characterizing oral masses for biopsy?
Oral malignant melanomas in dogs have a low metastatic rate.
Oral malignant melanomas in dogs have a low metastatic rate.
What does MST stand for?
What does MST stand for?
A long term survival or cure is possible in dogs if they are diagnosed with a non tonsillar SCC, rostral tongue, or ______.
A long term survival or cure is possible in dogs if they are diagnosed with a non tonsillar SCC, rostral tongue, or ______.
Match the treatments used to treat Canine Malignant Melanoma with a description of it.
Match the treatments used to treat Canine Malignant Melanoma with a description of it.
What is the MOST COMMON oral tumour in cats?
What is the MOST COMMON oral tumour in cats?
Feline oral SCC has a GOOD prognosis.
Feline oral SCC has a GOOD prognosis.
What is typically required for cats with squamous cell carcinoma to increase their survival rates?
What is typically required for cats with squamous cell carcinoma to increase their survival rates?
Tonsillar SCC especially in cats have detectable ________.
Tonsillar SCC especially in cats have detectable ________.
Match the prognostic indicators with a description.
Match the prognostic indicators with a description.
What is the most common cause of death for oral fibrosarcoma?
What is the most common cause of death for oral fibrosarcoma?
Oral fibrosarcomas always present with easily distinguishable high-grade histological features.
Oral fibrosarcomas always present with easily distinguishable high-grade histological features.
What is essential for odontogenic tumors (Acanthomatous Amelioblastoma) to be cured.
What is essential for odontogenic tumors (Acanthomatous Amelioblastoma) to be cured.
With Acanthomatous Amelioblastoma excellent prognosis with WIDE surgical excision (incl bone) minimum needs 1 ________ for margin.
With Acanthomatous Amelioblastoma excellent prognosis with WIDE surgical excision (incl bone) minimum needs 1 ________ for margin.
Match the Treatments and prognosis with the type of tumours.
Match the Treatments and prognosis with the type of tumours.
Where do Squamous Cell Carcinomas most commonly arise from?
Where do Squamous Cell Carcinomas most commonly arise from?
Leaving a nasal planum tumour left untreated is the best option.
Leaving a nasal planum tumour left untreated is the best option.
What are the three types of oropharyngeal injuries?
What are the three types of oropharyngeal injuries?
When an animal has Dysphagia, drooling, oral pain = pain on flexion of neck, Subcut emphysema, blood tinged saliva, pain on opening mouth, they are all ______ of oropharyngeal injuries.
When an animal has Dysphagia, drooling, oral pain = pain on flexion of neck, Subcut emphysema, blood tinged saliva, pain on opening mouth, they are all ______ of oropharyngeal injuries.
Match a type of exploration of a oropharyngeal wound, with a description.
Match a type of exploration of a oropharyngeal wound, with a description.
What is one of the main principles on palate surgery?
What is one of the main principles on palate surgery?
You would leave a palate surgery that is going to have a tongue/chewing, moving around all the time, to disrupt healing.
You would leave a palate surgery that is going to have a tongue/chewing, moving around all the time, to disrupt healing.
What is an oronasal fistula?
What is an oronasal fistula?
A bleeding palatine ulcer is most common from over palatine vessels – oral bleeding (can have ______).
A bleeding palatine ulcer is most common from over palatine vessels – oral bleeding (can have ______).
Match a type of Congenital Cleft to a feature.
Match a type of Congenital Cleft to a feature.
Name the type of clinical sign for Cleft Hard Palates?
Name the type of clinical sign for Cleft Hard Palates?
Surgical disorders of the salivary glands has fluctuating, painless swelling of the neck or within oral cavity in healthy dog.
Surgical disorders of the salivary glands has fluctuating, painless swelling of the neck or within oral cavity in healthy dog.
Name the 5 main locations for a sialocoele?
Name the 5 main locations for a sialocoele?
A cervical sialocoele, the dogs are (v. rare in cats) but are seen most often in dogs with the age being ______.
A cervical sialocoele, the dogs are (v. rare in cats) but are seen most often in dogs with the age being ______.
What is the primary goal when performing surgery for oral neoplasia?
What is the primary goal when performing surgery for oral neoplasia?
The presence of a draining sinus after a stick injury indicates the surgery has resolved the issue.
The presence of a draining sinus after a stick injury indicates the surgery has resolved the issue.
What is a common finding upon physical examination with Cervical Sialocoele?
What is a common finding upon physical examination with Cervical Sialocoele?
For dogs diagnosed with oral malignant melanoma, a treatment that includes a melanoma vaccine can increase the median survival time up to _______ months.
For dogs diagnosed with oral malignant melanoma, a treatment that includes a melanoma vaccine can increase the median survival time up to _______ months.
Match surgical procedures with their descriptions:
Match surgical procedures with their descriptions:
Which of the following is a critical consideration for surgical planning in mandibulectomy cases?
Which of the following is a critical consideration for surgical planning in mandibulectomy cases?
The primary goal of treatment for an oronasal fistula is to address the underlying infectious etiology.
The primary goal of treatment for an oronasal fistula is to address the underlying infectious etiology.
What is the most common type of oral tumor in cats?
What is the most common type of oral tumor in cats?
Oral fibrosarcomas are often described as being "Histologically ______ grade; biologically ______ grade."
Oral fibrosarcomas are often described as being "Histologically ______ grade; biologically ______ grade."
In the context of oral surgery, what does 'XEROSTOMIA' refer to?
In the context of oral surgery, what does 'XEROSTOMIA' refer to?
Antibiotics are always required as part of peri-operative care in patients undergoing oropharyngeal surgery.
Antibiotics are always required as part of peri-operative care in patients undergoing oropharyngeal surgery.
What is the recommended surgical approach for treating ranulas in dogs?
What is the recommended surgical approach for treating ranulas in dogs?
The TNM staging system assesses oral malignant melanoma based on three factors: Primary Tumor size, Regional Lymph Node involvement, and _______.
The TNM staging system assesses oral malignant melanoma based on three factors: Primary Tumor size, Regional Lymph Node involvement, and _______.
Why is it essential to identify/preserve the lingual nerve during salivary gland surgery?
Why is it essential to identify/preserve the lingual nerve during salivary gland surgery?
A fine needle aspirate (FNA) is generally the most effective method for accurately diagnosing primary masses in the oral cavity.
A fine needle aspirate (FNA) is generally the most effective method for accurately diagnosing primary masses in the oral cavity.
What is the primary concern regarding blood supply during a mandibulectomy?
What is the primary concern regarding blood supply during a mandibulectomy?
Prior to extubation after oropharyngeal surgery patients require a thorough ______ of the oropharynx.
Prior to extubation after oropharyngeal surgery patients require a thorough ______ of the oropharynx.
In managing penetrating oropharyngeal injuries from stick foreign bodies in dogs, why is thorough exploration crucial?
In managing penetrating oropharyngeal injuries from stick foreign bodies in dogs, why is thorough exploration crucial?
All congenital cleft palates require immediate surgical intervention upon diagnosis to ensure the survival of the puppy.
All congenital cleft palates require immediate surgical intervention upon diagnosis to ensure the survival of the puppy.
Why are steroids or NSAIDs avoided following oropharyngeal surgery?
Why are steroids or NSAIDs avoided following oropharyngeal surgery?
Questions and Answers
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Flashcards
Flashcards
Learning objectives for head and neck surgery?
Learning objectives for head and neck surgery?
To understand the principles of surgery specific to the head and neck, know relevant regional anatomy, and oral neoplasia in dogs and cats, management of lip trauma, surgery for palate defects, and surgical diseases of the salivary glands.
Key aspects of surgical planning?
Key aspects of surgical planning?
Know the anatomy, avoid damage to vital structures, appropriate positioning in surgery, dorsal/lateral open mouth, and good lighting.
Key aspects of anesthesia?
Key aspects of anesthesia?
Regional analgesia (nerve blocks), protect airways (cuffed ET tube, pharyngostomy, pack pharynx), and remember to tag and remove any packing.
How to prepare the oral mucosa?
How to prepare the oral mucosa?
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Key principles of surgical technique?
Key principles of surgical technique?
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Suture material?
Suture material?
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Control oral surgery bleeding?
Control oral surgery bleeding?
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How to manage post-operative soft tissue swelling?
How to manage post-operative soft tissue swelling?
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Post-operative?
Post-operative?
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Key considerations for nutrition?
Key considerations for nutrition?
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When are antibiotics needed?
When are antibiotics needed?
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Clinical Signs of Oral Disease?
Clinical Signs of Oral Disease?
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Types of benign oral masses?
Types of benign oral masses?
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List malignant oral masses?
List malignant oral masses?
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Oral tumors can arise from?
Oral tumors can arise from?
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Most common malignant oral tumors?
Most common malignant oral tumors?
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Most common benign oral tumors or masses
Most common benign oral tumors or masses
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What is the most common oral tumor??
What is the most common oral tumor??
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MOST COMMON – SQUAMOUS CELL CARCINOMA (>75%)?
MOST COMMON – SQUAMOUS CELL CARCINOMA (>75%)?
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Considerations for a biopsy?
Considerations for a biopsy?
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What does TO stand for?
What does TO stand for?
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What does T1 stand for?
What does T1 stand for?
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What does T2 stand for?
What does T2 stand for?
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What does T3 stand for?
What does T3 stand for?
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What is the N0 stand for?
What is the N0 stand for?
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What does N1 stand for?
What does N1 stand for?
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What does N2 stand for?
What does N2 stand for?
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What does MO stand for?
What does MO stand for?
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What does M1 stand for?
What does M1 stand for?
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Diagnostic staging of lymph-nodes?
Diagnostic staging of lymph-nodes?
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Radiographs for diagnostic staging?
Radiographs for diagnostic staging?
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Cross sectional imaging: CT
Cross sectional imaging: CT
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Cross sectional images: MRI?
Cross sectional images: MRI?
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TNM?
TNM?
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Surgery?
Surgery?
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What is radiation therapy?
What is radiation therapy?
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Surgery can increase:
Surgery can increase:
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Mandibulectomy Type A?
Mandibulectomy Type A?
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Mandibulectomy Type B?
Mandibulectomy Type B?
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Mandibulectomy Type C?
Mandibulectomy Type C?
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Mandibulectomy Type D?
Mandibulectomy Type D?
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Mandibulectomy Type E?
Mandibulectomy Type E?
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Mandibulectomy Type F?
Mandibulectomy Type F?
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Anatomical Considerations: Mandibulectomy?
Anatomical Considerations: Mandibulectomy?
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Blood supply (major risk haemorrhage)?
Blood supply (major risk haemorrhage)?
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Nerve Supply?
Nerve Supply?
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Salivary Ducts:
Salivary Ducts:
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Total Hemimandibulectomy?
Total Hemimandibulectomy?
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Rostral / Pre-maxillectomy
Rostral / Pre-maxillectomy
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Central (midsubstance); Caudal and Total Hemi
Central (midsubstance); Caudal and Total Hemi
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Maxillectomy Complications?
Maxillectomy Complications?
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Canine malignant melanoma ?
Canine malignant melanoma ?
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Immunotherapy?
Immunotherapy?
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Squamous Cell Carcinoma (SCC)?
Squamous Cell Carcinoma (SCC)?
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Poor prognostic indicators?
Poor prognostic indicators?
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Canine Oral SCC?
Canine Oral SCC?
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How long does it take to metastasis?
How long does it take to metastasis?
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Feline oral SCC
Feline oral SCC
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VERY DIFFERENT FROM CANINE
VERY DIFFERENT FROM CANINE
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Tonsils?
Tonsils?
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ORAL FIBROSARCOMA?
ORAL FIBROSARCOMA?
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Fibrous and Ossifying Epulides (Fibroma)?
Fibrous and Ossifying Epulides (Fibroma)?
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Excellent prognosis.
Excellent prognosis.
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PENETRATING STICK INJURIES - COMMON?
PENETRATING STICK INJURIES - COMMON?
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ALWAYS WITH STICK INJURIESVentral?
ALWAYS WITH STICK INJURIESVentral?
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Lip Injuries?
Lip Injuries?
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PRINCIPLES:
PRINCIPLES:
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BLEEDING PALATINE ULCERS IN CATS?
BLEEDING PALATINE ULCERS IN CATS?
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Clincal Signs –Cleft Hard Palate?
Clincal Signs –Cleft Hard Palate?
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Sialocoeles:
Sialocoeles:
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Study Notes
Study Notes
Principles of Oropharyngeal Surgery: Planning
- Know the anatomy to operate successfully.
- Vital structures such as facial nerves and blood vessels must be avoided.
- Appropriate patient positioning allows for better surgical exposure.
- Dorsal, lateral or open mouth positionings can be used.
- Good lighting provides optimal visualization.
Principles of Oropharyngeal Surgery: Anesthesia
- Nerve blocks like mandibular/maxillary regional analgesia can be used.
- Airways must be protected via cuffed ET tube, pharyngostomy, or pharyngeal packing.
- Ensure that all packing is tagged and removed post-surgery.
Principles of Oropharyngeal Surgery: Peri-operative Prep
- Clipping of the hair around the surgical site may be necessary.
- Weak povidone-iodine or aqueous 0.05% chlorhexidine is appropriate for oral mucosa.
Surgical Technique
- Any tension on the surgical site can lead to dehiscence.
- Use 2-layer closures involving mucosa & muscle.
- Appositional sutures, either simple interrupted or continuous, are recommended.
- Suture lines should not be placed over deficits.
- Exercise caution when using mouth gags, especially in cats.
Suture Material & Hemostasis
- Use medium to longer-lasting synthetic monofilament absorbable sutures like polydioxanone or poliglecaprone.
- 4/0 or 3/0 suture sizes are generally appropriate.
- Soft braided sutures (i.e. polygalactin 910, polyglycolic acid) should be avoided if inflammation is present.
- Oral surgery is highly vascular and can result in significant bleeding.
- Direct pressure or careful use of bipolar cautery are ways to reduce bleeding.
Post-Op Tissue Swelling
- Gentle tissue handling is critical to avoiding swelling.
- Steroids or NSAIDs can be prescribed individually, but they should never be used together.
- Mannitor swabs, wrapped ice blocks are useful methods.
- Post-surgical sedation using CRI such as butorphanol or medetomidine can help reduce activity/panting.
- An Elizabethan collar may be required.
Post-Surgery
- Remove all packing materials completely.
- Clean and suction the oropharynx prior to extubation.
- Implement a slow and quiet recovery protocol.
Nutrition
- Withhold food for a short period of 8-12 hours, but water can be offered sooner.
- Feeding tubes are an option.
- These include nasogastric or oesophageal tubes to bypass the oral cavity, or G-tubes (endoscopic or surgical) to bypass the oesophagus.
- SOFT food (balls/chunks but not gravy) assists passage.
- Encouraging eating via warmed/ aromatic food may be necessary for cats.
Antibiotics
- Peri-operative antibiotics are often not necessary due to excellent blood supply to oropharyngeal tissue and antimicrobial effects of saliva.
- Antibiotics are indicated for major procedures, infection, or in sick/immunocompromised animals.
- Antibiotic coverage should include common oropharyngeal organisms, specifically gram-positive aerobes and anaerobes.
- Amoxycillin clavulonate, ampicillin, or amoxycillin may be appropriate.
Clinical Signs of Oral Disease
- Ptyalism (drooling)
- Dysphagia or changes in eating patterns
- Inappetence/decreased appetite
- Weight loss
- Pain
- Halitosis
- Oral haemorrhage or epistaxis
- Anorexia (primarily cats)
- Loose or missing teeth
- Pawing at mouth/oral hypersensitivity
- Exophthalmos
- Psychogenic polydipsia
- Facial asymmetry
- Sneezing or nasal discharge
- Dyspnoea from large tonsillar or pharyngeal tumours
- Lymphadenomegaly
Oral Masses: Benign
- Papillomatosis (viral)
- Periodontal ligament tumours (Acanthomatous ameloblastoma)
- Odontogenic fibroma (Fibrous or ossifying epulis)
- Odontoma
- Granuloma or Inflammatory lesions
Oral Masses: Malignant
- Locally invasive, extending into bone and gingiva.
- Metastatic, especially in dogs.
- Includes malignant melanoma (MM), squamous cell carcinoma (SCC), fibrosarcoma (FSA), and osteosarcoma (OSA).
- Arise from buccal mucosa, mandible, maxilla, palate, dental structures, or tonsils.
Oral Tumours: Dogs
- Approximately 6% of all canine tumours are oral.
- About 50% of canine oral tumours are malignant.
- The four most common malignant oral tumours are malignant melanoma (MM); squamous cell carcinoma (SCC); fibrosarcoma (FSA); and osteosarcoma (OSA).
- Most common benign oral tumours/masses include epulides, odontogenic cysts, and gingival hyperplasia.
Oral Tumours: Cats
- In cats, oral tumours are the 4th most common tumour.
- 15-20% of all feline malignancies occur in this location.
- Over 90% of oral masses in cats are malignant.
- The most common is squamous cell carcinoma, representing over 75% of cases.
- These typically occur on or under the tongue, associated with tonsils, or around teeth.
- Most cases have metastasized to local lymph nodes by the time of diagnosis, and prognosis is poor.
Performing a Biopsy
- Fine needle aspiration (FNA) is generally unrewarding for oral masses.
- Incisional wedge or punch biopsy is the test of choice.
- Avoid necrotic tissue, as superficial tissues may not be representative.
- Collect samples from the edge and center of the lesion, planning the site to avoid contaminating normal tissue.
- Be aware that these biopsies often bleed extensively.
Canine Oral Malignant Melanoma (MM)
- The most common oral tumour in dogs is rare in cats.
- It is typically firm, black, and pigmented, but 33% are amelanotic.
- Ulceration is uncommon.
- Typically effects dogs aged 9-11 years, and more common in males.
- Pigmented breeds, such as Cocker Spaniels, GSDs, and Chow Chows, are at higher risk.
- It occurs on the gingiva/gums, lip, or tongue.
- 57% of patients have radiological evidence of bone loss at diagnosis.
- It is highly metastatic (80%), commonly to regional lymph nodes and lungs.
- 60-75% will have regional lymph node metastasis at diagnosis.
- The median survival time (MST) is 8-9 months, with 1-year survival under 35%.
- Early excision with 1-2 cm margins along with radiation or immunotherapy with melanoma vaccine is recommended.
Canine Oral Squamous Cell Carcinoma (SCC)
- It is the second most common oral tumour in dogs, affecting 20% of patients.
- 50% of tongue tumours in dogs are SCC.
- It is the most common oral tumour in cats, affecting 70% of patients.
- Appearance is often irregular, raised, cauliflower-like, and ulcerated.
- It occurs on the gingiva, lip, tongue, tonsil, or palate.
- It is locally invasive, causing bone lysis.
- Surgery should be performed with wide margins of 1-2 cm of clear bone.
- Cats are less tolerant of large surgeries, and short-term feeding tubes may be required.
Surgical Treatment: Oral Neoplasia
- Aggressive local therapy is applied when no evidence of metastatic disease.
- The most curative is surgical with appropriate margins.
- Can resect large parts of the skull including the zygoma, palate, maxilla, and mandible.
- Clean margins with a minimum of 1-2 cm disease-free bone based on imaging is the aim.
- Radiation therapy is the second most successful.
- This is used for inoperable tumours or tumours with known response to radiation therapy.
- Combinations consist of surgery as well as radiation and/or chemotherapy for dirty margins.
Types of Mandibulectomy
- Unilateral Rostral hemimandibulectomy
- Bilateral Rostral mandibulectomy
- Central hemimandibulectomy
- Caudal hemimandibulectomy
- Total hemimandibulectomy (left or right)
- Three quarter mandibulectomy
Mandibulectomy
- Important to know how much bone loss is present to plan the surgery.
- Bilateral rostral mandibulectomy crosses the midline.
- It should go behind tooth roots or roots removed if cut through.
- Reconstruct the lip using specific techniques so good cosmesis and function.
- Risks include a major hemorrhage from the mandibular aveolar artery.
- Avoid nerve damage, specifically the mandibular nerve (sensory branches of CNV – trigeminal).
- Preserve the mandibular and sublingual salivary ducts.
- Total hemimandibulectomy involves the entire mandible including the vertical ramus.
- Hemorrhage risk is high.
- The tongue droops on the resected side, which is improved by doing cheiloplasty at the lip commissure.
- Mandibular drift can occur.
Maxillectomy
- More difficult than mandibulectomy and harder to get a good margin.
- Rostral / Pre-maxillectomy can cross midline.
- Central, Caudal and Total Hemi cannot cross midline.
- Problems of dehiscence or oronasal fistula can occur.
- A risk of heamorrhage comes from the palatine and infraorbital vessels.
- Cosmesis and function is usually good.
Canine Oral Fibrosarcoma
- This represents 10-20% of canine tumors and is 3rd most common.
- Occurs in the average patient age 7-8 years, slightly younger than SCC/MM, in males.
- Tumors are flat, firm, ulcerated, multilobulated, and deeply attached.
- Radiography often shows locally invasive in gum and bone.
- Common with inadequate surgery (upto 46%) or death with recurrence.
- Metastasis is rare.
- Surgery is the cornerstone for TX of FSA.
Feline Oral SCC
- It is the most common oral tumour affecting 70% of pateints.
- Averages a 12 yo onset and is on the mandible, maxilla, sublingual & tonsillar.
- Bone involvement is COMMON & EXTENSIVE.
- This carries a poorer prognosis with SCC of the tonsil, tongue and caudal gingiva.
- Prognosis: POOR!!
- Less than 10% 12 month survival rate.
- MST is 44 days with using NSAIDs alone.
Feline Nasal SCC
- Often appears on eyelids, ears and nasal planum.
- Esp. white outdoor cats will get location of tumor.
- Treatable. location is everything.
- Early intervention leads to a best prognosis.
Oropharyngeal Injuries
- Can be animal bites or penetrating stick.
- Other objects obstructing the airway include a ball life threatening if not removed.
- Also can be linear FB caught around base of tongue more common in cats.
Lip Injuries
- Lacerations, avulsion can occur with trauma.
- Clean and preserve tissue
- Reattach to bone with suture around teeth or bone tunnels.
- Protect from licking, minimal tension.
Palate Surgery
- Bleeding ulcers more common in cats.
- Occurs with trauma from a tongue or over grooming more associate with pruritus.
- TREAT UNDERLYING SKIN DISEASE
- Oronasal fistula; most common due to tooth loss
Bleeding Palatine Ulcers in Cats
- This is related to increased trauma from the tongue or overgrooming, and associated with pruritus.
- Ulcers can be cauterized or excised, the palatine artery can be ligated, and granulation tissue can be left.
- The underlying skin disease should be treated.
Oronasal Fistula
- This is a tract between 2 epithelial-lined cavities, such as the nasal cavity and mouth.
- In most cases, it is due to tooth loss, requiring closure of the socket during dentals.
- Other causes include trauma, electric burns, tumor removal, or congenital deformity.
Congenital Cleft Palate
- Results from the incomplete fusion of primary or secondary clefts.
- Involve the lip, incisive alveolar ridge, and premaxilla.
- A cosmetic problem that surgically has excellent results and prognosis.
- Surgery is performed at 6 months old.
- Secondary Cleft: palatine, maxillary & incisive bones
Sialocoeles
- These are fluctuant and painless swellings of the neck or within the oral cavity in healthy dogs.
- It is important to know anatomy with how many glands, where ducts and open and important anatomical structures.
- Can affect the cervical (most common), sublingual, pharyngeal, parotid and zygomatic areas.
Cervical Sialocoele
- It is the most common type of sialocoele seen in practice.
- Dogs (v. rare in cats) - Often <4-5yo
- Anymore breed an increased incidence n German shepherd.
- Sublinqual Salivary glands 1° involved BUT remove both mandibular & sublingual CHAIN on affected side
Treatments
- Diagnostics can be done by clinical presentation also a periodic acid Schiff test.
- It can be removed by mandibular and sublingual glands bilaterally or with surgery (Fossum)
- The most common location is sublingual with secondary most the most common.
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