Page 47 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSA V A Manual of Canine and F eline Head, Neck and Thoracic Surger y
BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

➜ OPERATIVE TECHNIQUE 3.1 CONTINUED
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a illectomy ith an osteotome and mallet. esection of the prema illa and/or ma illa single-layer buccal mucosal closure is
e poses the nasal cavity. performed.

Closure PRACTICAL TIP
The labial mucosa is undermined to allow tension-
free apposition of the flap to the palatal mucosa. A Tension-free closure is imperative to avoid wound
dehiscence and subsequent oronasal fistula. Failure of
single-layer, mucosal closure is performed using
synthetic absorbable suture material in a simple second-intention healing for partial wound dehiscence
requires utilization of oronasal fistula repair techniques
interrupted or vertical mattress pattern.
POSTOPERATIVE CARE

Feed soft food for 2 weeks.

OPERATIVE TECHNIQUE 3.2

Total mandibulectomy

The dog is positioned in lateral
PATIENT POSITIONING recumbency. posure of the
caudal mandible can be
Lateral recumbency.
enhanced by retraction of the
labial commissures.
ASSISTANT
Optional.

ADDITIONAL INSTRUMENTS
Periosteal elevator; osteotome and mallet.

SURGICAL TECHNIQUE
Approach
The oral mucosa is incised labially/buccally (or with skin) and lingually from the mandibular symphysis to the ramus of
the mandible, at least 2 cm peripheral to the neoplasm.
Surgical manipulations
1 Elevate the buccinator muscle from the body of the mandible using a periosteal elevator.
2 Elevate the masseter muscle from the masseteric fossa of the mandibular ramus in a similar fashion.

3 Perform mandibular symphyseal osteotomy using a scalpel blade (possible in the cat) or an osteotome and mallet.
4 Displace the mandible laterally to allow elevation of the mylohyoid muscle medially and digastricus muscle
caudoventrally. Full-thickness incision of the lip commissure may be performed to gain additional exposure
of the caudal operative field.

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