Oropharyngeal Problems & Cervical Swellings

Question 1

what is a maxillectomy

Answer 1

removal or part of the upper jaw

any part of nasal, palate, orbit

Question 2

what is the main indication for maxillectomy

Answer 2

oral neoplasia

Question 3

what is mandibulectomy

Answer 3

removal of part of the lower jaw

Question 4

what is the main indication for mandibulectomy

Answer 4

oral neoplasia

Question 5

what is a sialocoele/salivary mucocoele

Answer 5

submucosal or subcutaneous collection of saliva

leakage of saliva from gland or duct

Question 6

where can sialocoele or salivary mucocoele occur

Answer 6

submandibular

cervical

sublingual (ranula)

Question 7

what is the etiology of sialocoeles (5)

Answer 7

1. idiopathic is most common (usually rupture of monostomatic sublingual salivary gland duct)
2. trauma
3. neoplasia
4. sialolithiasis
5. foreign body

Question 8

what are the clinical signs of sialocoeles (5)

Answer 8

1. fluctuating swelling
2. dysphagia
3. oral bleeding
4. hypersalivation
5. rare: respiratory obstruction

Question 9

how can you diagnose a sialocoele

Answer 9

aspiration

honey coloured, viscous and mucin on cytology

but can get inflammatory response if repeated drainage and infection

first aspiration is of most diagnostic quality

Question 10

what is a sialoadenectomy

Answer 10

removal of affected salivary glands

usually submandibular salivary gland complex (mandibular and monostomatic sublingual removed together)

Question 11

what is ranula marsupialization

Answer 11

open ranula into oral cavity

cutting a slit into an abscess or cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst or abscess. Sutured in this fashion, the site remains open and can drain freely.

Question 12

what are the acute oral signs of a penetrating stick injury (6)

Answer 12

1. dysphagia
2. blood tinged saliva
3. pain
4. pharyngeal laceration
5. pyrexia
6. pyothorax + mediastinitis

Question 13

what can be seen with an acute stick injury on rads

Answer 13

1. cervical emphysema (indicates a perforation)
2. tracking gas into thorax

Question 14

what is shown here

Answer 14

acute presentation of a penetrating stick injury

Question 15

what are the surgical goals of an acute presentation stick injury (2)

Answer 15

1. explore tracts and remove debris
2. oral or ventral cervical approach

Question 16

what is the chronic presentation of penetrating stick injury (4)

Answer 16

1. no emphysema
2. no pharyngeal laceration
3. neck swelling/abscess
4. +/- sinus tract

Question 17

what are the surgical goals of a chronic presentation of a stick injury (3)

Answer 17

1. remove debris and infected tissue
2. en bloc resection where possible
3. open + curette remaining tracts

Question 18

what is an oronasal fistual

Answer 18

communication between the oral and nasal cavity

Question 19

what are the clinical signs of an oronasal fistula (4)

Answer 19

1. chronic rhinitis
2. nasal regurgitation food
3. aspiration pneumonia
4. malnutrition

Question 20

what are cleft soft or hard palate defects

Answer 20

midline defects

Question 21

what are the etiologies of cleft soft or hard palates (2)

Answer 21

1. congenital (common)
2. acquired (head trauma)

Question 22

what should be done in congenital soft or hard palate cases (3)

Answer 22

1. check all puppies and kittens at birth
2. recommend euthanasia if found
3. refer for repair (high failure rates)

Question 23

what can be done for acquired soft or hard palate cases

Answer 23

amenable to surgical repair

repair early before maxillary fractures heal

chronic cases best to refer for flaps

Question 24

what are the etiologies of oronasal fistula

Answer 24

1. dental disease
2. neoplasia

Question 25

how are oronasaula fistuals fixed

Answer 25

surgical repair

high failure rates –> chronic infection of tissues, tension

refer