Wk 6 - Oral Cavity + Oropharynx

Oral cavity + Oropharynx parts

• _______________

• _______________

• _______________

• _______________

hard/soft palate; lips; tongue; salivary glands

Congenital oronasal fistula

• abnormal communication between oral and nasal cavities

  • involves _______________, _______________, _______________, and/or _______________

soft palate; hard palate; premaxilla; lip

Congenital oronasal fistula

• primary palate

  • _______________ and _______________

  • incomplete closure = _______________ or _______________

lip; premaxilla; primary celft; cleft lip

Congenital oronasal fistula

• secondary palate

  • _______________ and _______________

  • incomplete closure = _______________ or _______________

hard palate; soft palate; secondary cleft; cleft palate

Congenital oronasal fistula

• failure of fusion of 2 palatine shelves during fetal development

  • closure of fetal palate occurs at _______________ of gestation

• inherited

  • recessive or irregular dominant/polygenic traits

• nutritional

  • inadequate _______________

• hormonal

  • _______________

• mechanical

  • _______________

• toxic/viral

25-28d; folic acid; steroids; in utero trauma

Congenital oronasal fistula

• signalment = brachycephalics

  • _______________

  • _______________

  • _______________

  • _______________

  • _______________

bostons; pekingese; bulldogs; miniature schnauzer; siamese

Congenital oronasal fistula

• signalment

  • _______________ > _______________

• Hx

  • difficulty _______________

  • nasal regurg or discharge

  • failure to thrive

females; males; rhinitis/aspiration pneumonia

Congenital oronasal fistula

• medical management

  • _______________ to decrease incidence of _______________ until old enough for Sx

  • Sx = _______________

tube feeding; aspiration; esophagostomy

Congenital oronasal fistula - Sx

• delayed until at least _______________ of age

• _______________

• _______________ techniques

8-12wk; sliding bipedicle flaps; overlapping flap

Closure of primary cleft

• _______________ to separate nasal and oral cavity

• _______________

• may require _______________

mucosal flap; modified Z-plasty; rostral maxillectomy

Acquired oronasal fistula - Causes

• trauma

  • _______________

  • _______________

  • _______________

• _______________

bites; gunshot; electrical burn; dental dz

What is the main Hx for a patient with acquired oronasal fistula?

chronic rhinitis

Acquired oronasal fistula - Sx

• successful repair

  • _______________

  • _______________

  • _______________-free

• _______________ closure

well-supported; airtight; tension; direct

Acquired oronasal fistula - Sx

• _______________ techniques are more successful

• Complications:

  • _______________

  • _______________

flap; dehiscence; recurrence

Lip avulsions

• Cats

  • secondary to _______________

• Dogs

  • due to _______________

• avulsion of _______________ lip and associated labial mucosa from adjacent _______________

HBC; bites; mandibular; gingiva

Cheiloplasty

• lip fold _______________ secondary to excessive _______________ tissue

dermatitis; mandibular labial

Antidrool Cheiloplasty

• _______________

• decreases loss of food and saliva due to excessive eversion or denervation of the lower lip

• oral function normal but _______________ can occur at Sx site

• will have _______________ and _______________

cheilopexy; inflammation and infection; permanent flap adhesion; cheek scars

Tongue Disorders - Trauma

• _______________

  • paper shredder, cage grate, chain link fence, bite wounds

• Tx

  • apposition of _______________ tissue and then _______________ with _______________ suture

entrapment; deep muscular; epithelium; absorbable monofilament (3/0 or 4/0)

Tongue disorders - Neoplasia

• CS

  • halitosis, hypersalivation, oral hemorrhage, difficult _______________, swallowing

• Tx

  • _______________

prehension; glossectomy

Salivary mucoceles

• collection of saliva that has leaked from a damaged _______________ or _______________

salivary gland; duct

Salivary mucocele

• locations

  • _______________

  • _______________

  • _______________

  • _______________

cervical; sublingual (Ranula); pharyngeal; zygomatic

Salivary mucocele - Pathophysio

• _______________ of salivary gland or duct → leakage of saliva

• NOT a _______________

• cause is identified _______________

tearing; cyst; rarely

Salivary mucocele - Pathophysio

• NOT a cyst

  • cysts are lined by _______________

  • mucoceles are lined by _______________ (secondary to inflammation)

• Causes: FB, trauma, sialoliths suggested

• _______________ = most commonly affected

epithelium; granulation tissue; sublingual salivary gland

Salivary mucocele - Dx

• _______________ > _______________

• all breeds susceptible

• Hx depends on location

  • asymptomatic - _______________

  • abnormal prehension and bleeding - _______________

  • resp distress and dysphagia - _______________

  • enopthalmos and divergent stabismus - _______________

dogs; cats; cervical; ranula; pharyngeal; zygomatic

Salivary mucocele - Dx

• Hx depends on location

  • Cervical - _______________

  • Ranula - _______________

asymptomatic; abnormal prehension and bleeding

Salivary mucocele - Dx

• Hx depends on location

  • Pharyngeal - _______________

  • Zygomatic - _______________

resp distress and dysphagia; enophthalmos and divergent stabismus

Salivary mucocele - Dx

• aspiration of clear, yellowish or blood tinges, _______________, _______________ fluid with _______________ cell count = saliva

viscous; mucoid; low

Salivary mucocele

• medical management

  • _______________ may be necessary for animals in resp distress

  • _______________ and _______________ complicates Sx

emergency drainage; palliative; repeated drainage

Salivary mucocele - Sx

• complete excision of _______________ and _______________ are curative

gland-duct complex; draining mucocele

Salivary mucocele - Sx

• side of origin determined by _______________, _______________ or exploration of mucocele

oral exam; palpation

Mandibular and Sublingual Salivary Gland Exision

• _______________ and _______________ mucoceles

• need to excise originating gland and duct complex via _______________ or _______________ incision and then can drain

  • ranula = _______________

cervical; sublingual; lateral; ventral; marsupialization

Mandibular and Sublingual Salivary Gland Excision

• Post-op care

  • _______________ should be done

  • bandage changes with _______________ placement should be done for _______________ mucoceles

  • soft food for _______________ after ranula marsupilation or drainage of pharyngeal mucocele

histopath; penrose draing; 3-5d

Mandibular and Sublingual Salivary Gland Excision

• Post-op care

  • soft food for 3-5d after:

    • _______________ OR drainage of _______________

ranula marsupialization; pharyngeal mucocele

Mandibular and Sublingual Salivary Gland Excision

• Complications

  • _______________

  • _______________

  • mucocele recurrence

  • prognosis = _______________ if dz accurately diagnosed and excision is _______________

seroma; infection; excellent; complete

Mandibular and Sublingual Salivary Gland Excision

• Mucocele recurrence

  • side _______________

  • inadequate _______________

  • to minimize, you should be attention to _______________

misdiagnosed; gland excision; anatomy

What is the main thing that you want to perform while surgically correcting a congenital oronasal fistula?

tension-free closure

T/F: Lip avulsions are usually maxillary

False (usually manibular)

Why does the oral cavity heal so quickly?

good blood supply

What should you also do when removing the sublingual gland for correcting a mucocele?

remove the mandibular salivary gland as well (close together)