Oral surgical conditions Flashcards
what are the principles of oral surgery?
- Use atraumatic technique
- Control haemorrhage using pressure, ligation or appropriate electrosurgery
- Prevent tension; make flaps 2 to 4 mm larger than the defect
- Support flaps; do not suture over defects
- Use appositional sutures (e.g., simple interrupted, simple continuous, cruciate – consider locked horizontal mattress or vertical mattress)
what suture materials are used for oral surgery?
- Monofilament, absorbable materials providing wound support for between 14-28 days (e.g., poliglecaprone, glycolide, polygytone, etc.)
- Multifilament, absorbable materials providing wound support for between 10-21 days (e.g., glycomer 910, Lactomer 9-1, glycolic acid, etc.)
- could be an infection risk, due to larger surface area
- can cause less oral irritation due to being softer
- can get a rapid disolving multifilament - might be the best of both world
what are the types of cleft palate?
Birth defect leading to abnormal opening between the mouth and nose
- Lip (primary cleft palate, cleft lip, harelip)
- Unilateral
- Bilateral
- Along roof of the mouth (secondary cleft palate)
- Affecting hard palate only
- Affecting soft palate only
- Affecting both hard and soft palate
- Both
what seperates primary and secondary palatine defects?
the incisive fissure - rostral of incisive fissure is primary, caudal of incisive fissure is secondary
if they are rostral then there are less issues, caudal fissures often cause food to enter the nasal cavity
what is shown here?
palatine hypoplasia - this dog has bilateral
the soft palate has not grown fully
what are the clinical signs of palatine defects?
what is the managemet of these animals?
what is the aftercare for animals that have palatine surgey?
what are the complications?
clinical signs
* Stunted growth due to poor weight gain
* Breathing difficulties upon exertion
* Coughing or gagging especially when eating or drinking
* Nasal discharge that may include food
* Infection or pneumonia due to food aspiration
* Abnormal visual appearance with cleft lip defect
managment:
* Breeders commonly euthanase affected individuals
* Otherwise, management usually surgical
* Usually wait until affected individual is 3-6 months old
* Numerous ways on surgical management dependent on type of cleft, etc.
* Prone to dehiscence and requirement for repeat surgery
* primary defects often dont have clinical effects so can be left - but owners might want suregery for cosmetic reasons - ethical issues
aftercare:
* Give antibiotics for individuals with pneumonia or nasal infection
* Elizabethan collar for 2-3 weeks to stop self-trauma
* Soft food for 3-4 weeks
* No hard chews or toys, etc. that can be chewed
* Use of oesophagostomy feeding tube appears to make little or no difference to likelihood of dehiscence
* Do not breed from affected individuals, etc.
complications:
Partial or complete dehiscence
Nasal discharge or sneezing
* Continue coughing or gagging due to short soft palate
what can cause oral-nasal fistulas?
how can thye be fixed?
sticks
- using cartilage (eg from the ear) - to provide layer one of closure (multi layer closure is optimal)
- then remove a tooth and use tissue from the bucal mucossa to provide layer two
what are the issures with mandibular symphsyseal seperation?
how do you fix this?
causes malocclusion of the teeth
- loop suture round the canines teeth ties externally - mihgt not alinge propperly
- dental acrylic to splint stabalise - over the canines and incisors
how can you fix rostal maxillary fractures?
- The sutured defect and placement of orthodontic buttons and elastics for apposition and realignment
- can then place acrylic splint over the buttons and elastics for further stabalisations
what are the issues of CT scans of cat heads?
cat head is small and therefore the quality is not optimal - however still useful
dental radiographs will have better quality but superimposition can make seeing fracture lines ared to see
what surgical diseases affect the salivary gland?
- Salivary gland and duct injury
- Salivary fistula
- Sialoliths
- Salivary gland neoplasia
- Mucocoeles - normally affets the sublingual and mandibular gland
what is a mucocoele?
a leakage and build up of salive outside salivary gland/duct system - causes lumps
often have then in more than one location due to the fact that the the sublingual and mandibular glands and duct are involved with each other
can be sublingual, submandibular, pharangeal (this can then cause issues with swallowing)
what is a ranula?
how can they be treated?
a mucocoele that is sublingual (under the tongue)
Treatment:
* marsupialistion - the saliva will then just drain into the mouths, however can then heal back over and will reoccur OR
* excision of the mandibular and sublingual glands
