Page 1925 - Cote clinical veterinary advisor dogs and cats 4th

Temporomandibular Joint Luxation 961.e5

○ Remove the dowel, but keep the mouth PROGNOSIS & OUTCOME SUGGESTED READING
closed to maintain joint reduction. Excellent if no regional fracture; fair to poor Lantz GC, et al: Fractures and luxations involving the
VetBooks.ir weeks (or perform maxillofacial fixation if regional fracture ± ankylosis, particularly in editors: Oral and maxillofacial surgery in dogs and Diseases and Disorders
○ Apply a slightly snug tape muzzle for 1-3
temporomandibular joint. In Verstraete FJM, et al,
with the modified reverse suture labial
cats. Philadelphia, 2012, Saunders, pp 321-332.
immature/adolescent animals
button technique). The muzzle should be
sufficiently loose to allow the animal to PEARLS & CONSIDERATIONS ADDITIONAL SUGGESTED
lap up water and liquefied food. READINGS
○ Recovery from sedation/anesthesia, with Comments Capron TM: Traumatic temporomandibular joint
particular attention to aspiration (e.g., • The most common form, rostrocaudal TMJ luxation: comparative anatomy of the temporo-
remove muzzle immediately if vomiting luxation, is usually unilateral. mandibular joint. Vet Comp Orthop Traumatol
appears imminent) • Do not force the mouth closed in patients 8:58, 1995.
• Regional fractures (condylar process of presenting with the mouth wide open. Çetinkaya MA: Temporomandibular joint injuries and
mandible; mandibular fossa/retroarticular Manual correction of open-mouth jaw ankylosis in the cat. Vet Comp Orthop Traumatol
process of temporal bone) are usually treated locking is achieved by opening the mouth 25:366, 2012.
conservatively without surgical intervention. a little further, pressing the coronoid process Goodman AE, et al: Modified labial button technique
for maintaining occlusion after caudal mandibular
Owners must be warned of possible compli- medially, and closing the mouth. Definitive fracture/temporomandibular joint luxation in the
cations such as TMJ ankylosis, which may surgical treatment of open-mouth jaw locking cat. J Vet Dent 33:47, 2016.
become apparent 6-8 weeks after traumatic is achieved with unilateral or bilateral partial Reiter AM: Symphysiotomy, symphysiectomy, and
incident. Muzzling is contraindicated. zygomectomy, partial coronoidectomy, or a intermandibular arthrodesis in a cat with open-
combination of both procedures (p. 708). mouth jaw locking: case report and literature review.
Chronic Treatment J Vet Dent 21:147, 2004.
Chronic TMJ luxation: Technician Tips Schwarz T, et al: Imaging of the canine and feline
• Maxillomandibular fixation: tape muzzle, • Patients with maxillofacial fixations may have temporomandibular joint: a review. Vet Radiol
modified labial button technique, or inter- compromised thermoregulation and should Ultrasound 43:85, 2002.
arch splinting for 4-6 weeks not be let outdoors on warm or hot days.
• Condylectomy and bone fragment resection Restriction in mouth opening also bears RELATED CLIENT EDUCATION
indicated for severe regional fractures result- the risk of aspiration in the regurgitating SHEETS
ing in TMJ ankylosis and arthrosis or vomiting patient, requiring extra vigilance
during patient monitoring. Consent to Perform General Anesthesia
Nutrition/Diet • To reduce the possibility of local pyoderma How to Use and Care for an Indwelling Feeding
If normal prehension of food is not possible from a soiled muzzle, tape muzzles may be Tube
(e.g., complex jaw fractures, severe swelling), removed during drinking and eating and put AUTHOR & EDITOR: Alexander M. Reiter, DVM, Dr.
placement of an esophagostomy feeding tube back in place after feeding is completed. med. vet., DAVDC, DEVDC
may be needed for nutritional support (p.
1106).

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