Page 41 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

stump is rapidly covered by epithelium. Loss of approx- Neoplasia
imately one-third of the body of the tongue may be well Protuberant ulcerated lesions should always be investi-
VetBooks.ir amounts of tongue loss by sucking in liquid food or tossing gated by biopsy before resection (or before euthanasia if
tolerated in dogs. Animals compensate for greater
the lesion appears to be too extensive for surgery or radia-
boluses of food into the oropharynx. Sloughing of part of
tion therapy). Lingual eosinophilic granuloma, which is
the tongue is more likely to be troublesome in cats; even
though they can eat and drink, they may be unable to treated medically with good results, appears similar to an
groom effectively (Lewis and Reiter, 2011). invading neoplasm in some cats and dogs. The most
Other thermal burns may be caused by eating over- common malignant lingual tumour is SCC.
heated foods. Oral injury from direct ingestion of caustic Tongue masses are resected with good results if the
agents is less likely to occur in cats than dogs because of resection can be confined to the free rostral or the dorso-
their fastidious eating habits. Cats may get tongue burns caudal portions. Partial surgical resection is likely to result
when such agents are contacted during self-grooming. in significant haemorrhage. Clamping the tongue caudal to
The lesions are typically acute-onset ulcers covered by the excision site with non-crushing tissue forceps greatly
necrotic debris. Initial therapy is copious lavage with aids in controlling bleeding. Ideally, tongue tissue is
saline, followed by conservative management. removed as a wedge so that the mucosa can be apposed
with synthetic absorbable sutures. Malignancies located
deep in the root of the tongue or causing the tongue to be
Foreign bodies
tied down to the adjacent soft tissues are not amenable to
Linear foreign bodies caught around the tongue can ‘saw’ complete resection (Culp et al., 2013).
their way into the lingual frenulum, causing a granulating
mass similar in appearance to SCC or eosinophilic granu- Other conditions
loma, both observed in this location in cats. Treatment is
removal of the foreign body. Barbed objects or bone In dogs with ankyloglossia, a congenital anomaly charac-
spicules may require incision along the object for removal terized by fusion between the tongue and floor of the oral
and prevention of further damage. Glossitis may result from cavity (‘tongue-tie’), frenuloplasty can be used to free the
plant foreign material penetrating the dorsal lingual mucosa tongue (Temizsoylu and Avki, 2003).
during self-grooming. Treatment requires scraping of the Puppies born with macroglossia, individuals with an
lingual mucosa to remove the particulate plant material. extremely long tongue (commonly seen in brachycephalic
animals) and those that cannot retract it due to a neuro-
Calcinosis circumscripta logical deficit may suffer from prehension difficulties, des-
iccation and ulceration of the tongue surface. Resection of
Well defined mineralizations in the rostral portion of the the rostral portion of the tongue may be of benefit.
tongue (Figure 3.7) are more common in young large-
breed dogs. The cause of deposition of amorphous miner-
alized material in lingual tissue is unknown, although the Palate
rostral location and the young age of the patients suggest
that mechanical trauma or chemical agents may be aetio-
logical factors. Treatment involves resection of affected Congenital palate defects
tissue and apposition of the incised edges with synthetic In contrast to humans (where the upper lip is formed by
absorbable suture material. maxillary and medial nasal processes), in dogs and cats the
upper lip and primary palate are formed by midline fusion of
3.7 the maxillary processes (Reiter and Holt, 2012). Lateral pala-
tine processes move towards the midline and fuse with the
a Lingual
calcinosis nasal septum originating from the nasal process. This con-
circumscripta in a stitutes the secondary palate, which will ossify (hard palate),
dog. b except in the caudal part where it will form the soft palate.
radiograph of the Defects of formation of the lip and palatal structures
e cised tissue may be inherited or may result from an insult during fetal
sho ing a development (intrauterine trauma or stress). In most cases
circumscribed
lesion containing the cause is an intrauterine insult. Brachycephalic breeds
material ith bone are at higher risk.
density that is
(a) arranged in lobules. Cleft lip
Congenital defects of the primary palate (cleft lip) appear
as a lip defect only or as a defect of the lip and most
rostral hard palate (Figure 3.8). They may be associated
with abnormalities of the secondary palate. As in children,
unilateral cleft lips in dogs are more commonly on the left
side. Except for being externally visible, cleft lips rarely
result in clinical signs beyond mild local rhinitis, and repair
may be performed for aesthetic reasons. Surgical success
depends on tension-free apposition of well vascularized
tissue flaps positioned to separate the oral and nasal
spaces. Attempts to close the defect by simple sliding
procedures are rarely successful because there is no
connective tissue bed to support the flaps (Harvey and
(b)
Emily, 1993).

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