Section VII: Digestive- Oral Cavity

Question 1

Kawabe JAVMA 2015

RT for OMM

Answer 1

• Dogs received orthovoltage, megavoltage, or electron beam RT
• Adjunctive tx: debulking surgery, chemo, or both
• MST for stage 1, 2, 3, 4 melanoma were 758 d, 278d, 163 d, and 80 d, respectively
• MST differed significantly between dogs w/ stage I and those with other dz stages
• In dogs with stage III, risk of death was higher in those that received orthovoltage than those megavoltage
• Severe adverse effects were ID in 9 dogs: oronasal fistula 5.4%, mandibular fx 1.8%, trismus 0.9%

Question 2

Mullins JAVMA 2015

One staged repair of bilateral hypoplastic soft palate in a dog

Answer 2

• split thickness of soft palate hinged flap and bilateral buccal mucosal rotation flaps
• mild sneezing and nasal discharge
• normal soft palate length was not achieved
• normal function not obtained but good QOL

Question 3

Sarowitz JSAP 2017

Oral tumors- outcome/prognostic factors

Answer 3

• Median cause-specific survival was shortest for malignant melanoma (206 d) and osteosarcoma (209 d)
• Local recurrence was highest for fibrosarcoma (54.2%)
• Distant metastatic rate was highest for malignant melanoma (30%)
• Curative-intent surgery resulted in complete surgical margins in 85.2%
• Acanthomatous ameloblastoma most common in this study
• Prognostic factors for outcome include tumor type, size, completeness of excision and age.

Question 4

Riggs JAVMA 2018

Oral SCC or Fibrosarcoma

Answer 4

• MST for all dogs was 2049 d, not reached for dogs with SCC and only 557 d for dogs w/ FSA
• Tumor type significant predictor of survival time
• Dogs w/ postop RT after incomplete excision of oral SCC had longer MST (2051 d) than dogs w/ no RT and incomplete excision (181 d)
• Postop RT of dogs w/ incompletely excised FSAs did not offer protective value (299 d w/ RT, 694d w/o)

Question 5

Cray JAVMA 2018

Acute Masticatory MM Compartmental syndrome

Answer 5

• Dog w/ sudden onset of severe skeletal mm swelling, pain and dysfunction
• Emergent fasciotomy of temporalis and masseter mm were performed
• Plus medical management w/ corticosteroids and analgesics
• Diffuse facial swelling resolved in 1 week
• Serologic testing negative
• Histo consistent w/ myositis

Question 6

Grimes JAVMA 2019

Histo of lnn in dogs with OMM and SCC

Answer 6

• Prevalence of lymph node metastasis did not differ significantly btw dogs w/ OMM 37% and dogs with OSCC 29%
• Distant metastasis was ID in 41% of dogs with OMM and suspected in 1 dog with OSCC
• MRLN was affected in 13/16 dogs w/ lymph node metastasis and 3 did not have concurrent metastasis to an MLN
• Metastasis was ID in lnn contralateral to primary tumor in 4/17 dogs
• Bilateral lymphadenectomy of MLN and MRLN is recommended for these dogs

Question 7

Doyle VCOT 2019

Angiographic Study of Superior Labial Musculomucosal Flap

Answer 7

• All angiograms demonstrated that superior and inferior labial a were located w/in musculomucosal layer of labia
• At the junction of rostral and cd half of upper lip, extensive choke anastomoses joined the angiosome of the infra-orbital a.
• The inferior labial a perfused the cd half of the lower labium and extensive choke anatomoses w/ middle and rostral mental a.
• Superior labial flap survive to level of canine tooth
• Inferior labial flap width would be narrower, but could be just as long as superior labial flap

Question 8

Verganti JSAP 2017: Oncept Melanoma Vacc in UK

Answer 8

• Sixty-nine dogs were included; 56 dogs, staged I to III, and with previous locoregional therapy, had a median survival time of 455 days.
• No significant prognostic factors were identified for this population.
• Of the 13 patients with macroscopic disease treated with vaccine alone or in combination therapy, eight showed clinical response. (palliative); 44.4% response rate
• Three patients with stage IV oral malignant melanoma survived 171, 178 and 288 days from diagnosis.
• Similar to U.S response

Question 9

Tuohy Vet Surg 2019: Bilateral Cd Maxillectomy for tumors that cross palatal midline (Sarcoma and Osteochondrosarcoma)

Answer 9

• Both tumors were resected with complete histologic margins.
• The defects were closed with local buccal mucosal flaps, with or without a unilateral angularis oris flap.
• Esophagostomy tubes were placed at time of surgery to bypass oral feeding.
• Incisional dehiscence and subsequent oronasal fistula formation occurred as a postoperative complication in both dogs (3 and 10 days, respectively).
• Both were successfully repaired with a combination of local buccal mucosal flaps and the angularis oris flap.
• Both dogs had good functional outcome and quality of life after recovery from revision surgery.

Question 10

Thierry VRU 2018: CT appearance of canine tonsillar neoplasia

Answer 10

• Carcinoma was diagnosed in 11 dogs, melanoma in 2 and lymphoma in 1 dog.
• Specific CT features of the tonsil and regional lymph nodes did not differentiate neoplastic from nonneoplastic tonsillar diseases, but regional lymph node CT features were useful for diagnosis in some cases.
• Marked enlargement (width ≥ 18 mm, 12/18), heterogeneity (16/18), and loss of the hypoattenuating hilus (18/18) of the medial retropharyngeal lymph node were common concomitant features of tonsillar neoplasia.
• The medial retropharyngeal and mandibular lymphadenomegaly was ipsilateral to the neoplastic tonsil in 8/12 and 6/9 dogs, respectively.
• Five dogs demonstrated little or no enlargement of the tonsil despite the associated metastatic lymphadenomegaly.
• Tonsillar neoplasia should therefore be considered as a differential diagnosis for dogs with CT evidence of isolated medial retropharyngeal lymphadenomegaly (regardless of normally sized tonsils), or of any enlarged tonsil with no associated lymphadenomegaly.