E2- Head and neck surgery

Question 1

Where does lip fold pyoderma occur?

breeds?

Answer 1

moist dermatitis/pyoderma just caudal to canine teeth

foul odor

painful

pendulous lipped breeds: spaniels, retrievers, setters

Question 2

Treatment of lip fold pyoderma

Answer 2

conservative therapy

surgical resection

Question 3

What is labial avulsion?

Which lip more common?

Answer 3

shearing trauma- avulses along mucogingival line leaving very little soft tissue for reattachment

usually lower lip

Question 4

Treatment for labial avulsion?

Answer 4

suture reconstruction alone effective for maxillary lesions

suture reconstruction alone often fails on lower lip bc: limited soft tissue, edema and swelling of lip increases weight, suture subjected to movement when eating and drinking

Question 5

What is the button?

Answer 5

absorb tension- prevent necrosis of the skin

Question 6

What is important to remember when suturing?

Answer 6

start suturing at lip margin to avoid step deformity

Question 7

Lip reconstruction flap options

Answer 7

Question 8

Four major salivary glands (canine)

Answer 8

Parotid

Mandibular

Sublingual

Zygomatic

Question 9

What is the additional salivary gland in the cat?

Answer 9

molar salivary gland- formerly called mucosal bulge

Question 10

Nonpainful fluctuant swelling- suspect ____

Answer 10

mucocele

Question 11

Most common dz of the salivary system in dogs and cats?

Breeds?

Answer 11

salivary mucocele

german shepard and poodle overrepresented

Question 12

What is a mucocele?

Answer 12

accumulation of saliva w/in a nonepithelial, nonsecretory lining

soft, nonpainful swelling -maybe painful if in acute inflam stage of if secondary infection

Question 13

What gland is most commonly affected in mucoceles?

Answer 13

sublingual gland

Question 14

Most common presentation is ____

Answer 14

cervical mucocele

Question 15

This is a _____ sublingual swelling

Answer 15

Ranula

Question 16

This is a ____ mucocele

Answer 16

Pharyngeal

Question 17

Pharyngeal mucoceles can cause

Answer 17

respiratory distress and dysphagia

least common presentation but important differential for patients presented with a pharyngeal mass

Question 18

Zygomatic salivary gland mucocele clinical signs and Ddx

Answer 18

consistent retrobulbar disease- exophthalmos, protrusion of 3rd eyelid, subconjunctival saliva

Ddx: retrobulbar cellulitis/abscess but not usually painful

Question 19

Definitive treatment of salivary mucocele

Answer 19

surgical removal of the involved gland = definitive tx

percutaneous aspiration of accumulated saliva

marsupialization of ranula- salvage procedure

lancing pharyngeal mucocele

Question 20

salvage procedure for mucocele in ranula?

Answer 20

marsupialization of ranula- salvage procedure

Question 21

What do we need to be cautious for sublingual salivary gland adenectomy?

Answer 21

_***lingual nerve****_

Question 22

Why cant we just remove the sublingual gland?

Answer 22

its too close to mandibular gland and duct

Question 23

Definitive surgical treatment of the cervical mucocele, ranula, or pharyngeal mucocele of sublingual gland is ____

Answer 23

excision of the gland

Question 24

T/F when removing salivary glands, ligation of the ducts is necessary

Answer 24

false- not necessary

Question 25

T/F: if you leave any salivary tissue behind it will recur

Answer 25

TRUE

Question 26

What is a common mistake in salivary gland removal?

Answer 26

mandibular LN gets very big and remove that instead of salivary gland

Question 27

Does the mucocele need to be removed?

Answer 27

NO

mucocele is granulation tissue lined “sac” filled with saliva and inflam exudate

just drain contents- will resolve if affected gland is completely removed

Question 28

Prognosis for salivary mucocele

Answer 28

excellent prognsis

recurrence after gland resection is less than 5%

Question 29

Parotid Sialocele/fistula

Answer 29

trauma/rupture of parotid duct- duct is large and easy to identify

treatment options: ligation proximal to defect, excision of gland