Bilateral Lip Avulsion and Mandibular Symphyseal Separation in a Cat

Yıl 2022, Cilt: 1 Sayı: 2, 23 - 26, 15.05.2023

Yalçın Alper Özturan , Özge Özcan , Onur Halıcıoğlu

Öz

Objective: Orofacial trauma in dogs and cats usually results in lip avulsion and symphyseal mandible separation. Bite wounds and traffic accidents are common causes. This study aimed to describe a successfully treated case of bilateral lip avulsion and mandibular symphyseal separation in a cat.
Material and Methods: The cat's owner claimed that the animal underwent two unsuccessful surgeries in nearby veterinary hospitals after being injured in a car accident a month earlier. Euthanasia was recommended in every clinic and hospital the animal's owner visited, therefore the owner decided to bring the animal to the faculty hospital. Hemimandibles were separated from each other and the cat was depressed during the examination. Lips were avulsed bilaterally from the mandibles, puss and food remnants were observed in the avulsed areas.The cat was anesthetized and the avulsed areas were flushed and debrided. A cerclage wire was knotted between the canine and premolar teeth to secure the hemimandibles. The buccal area's mucosal layer was sutured to the ventral palatal areas to relieve suture tension. Meloxicam, pantoprazole, amoxicillin-clavulanic acid, and chlorhexidine were recommended for 7 days, as well as an Elizabethan collar, liquid feeding, and weekly control visits for 2 months. Sutures and the wire were removed on the postoperative 14th and 60th days.
Results: The animal recovered perfectly without any complications after two months.
Conclusion: Preoperative interventions and proper surgical planning that takes into account the forces on the tissues and the locations of the separation and dehiscence lead to success in challenging cases.

Anahtar Kelimeler

Avulsion, Cat, Cerclage Wire, Lip, Symphysis Mandibula Separation

Teşekkür

The authors would like to thank Ibrahim AKIN.

Bir Kedide Bilateral Dudak Avülziyonu ve Symphysis Mandibula Ayrılması

Öz

Amaç: Köpeklerde ve kedilerde orofasiyal travma genellikle dudak avülziyonu ve symphysis mandibula ayrılmasıyla sonuçlanır. Isırık yaraları ve trafik kazaları yaygın nedenlerdir. Bu çalışma, bir kedide başarıyla tedavi edilen bilateral dudak avülziyonu ve symphysis mandibula ayrılması vakasını tanımlamayı amaçladı.
Materyal ve Metot: Kedinin sahibi, kedinin bir ay önce bir trafik kazasında yaralanmasının ardından yakınlardaki hayvan hastanelerinde iki başarısız ameliyat geçirdiğini iddia etti. Hayvan sahibinin gittiği her klinik ve hastanede ötenazi önerilmiş, bu nedenle hayvan sahibi hayvanı fakülte hastanesine getirmeye karar vermiştir. Klinik muayenede hemimandibulalar birbirinden ayrılmıştı ve kedi depresif bir haldeydi. Dudaklar mandibulalardan bilateral olarak avülse olmuş, avülse bölgelerde irin ve yemek kalıntıları görüldü. Kedi anesteziye alındı, avülse alanlar yıkandı ve debride edildi. serklaj teli hemimandibulaları sabitlemek için kanin ve premolar dişler arasından düğümlendi. Bukkal bölgenin mukozal tabakası dikiş gerilimini azaltmak için ventral damak bölgelerine dikildi. Yedi gün meloksikam, pantoprazol, amoksisilin-klavulanik asit ve klorheksidin, 2 ay Elizabeth yakalık, sıvı beslenme ve haftalık kontrol randevuları önerildi. Dikişler ve serklaj teli postoperatif 14. ve 60. günlerde alındı. Bulgular: Hayvan, iki ay sonra herhangi bir komplikasyon olmaksızın mükemmel bir şekilde iyileşti.
Sonuç: Preoperatif müdahaleler, dokular üzerindeki kuvvetleri ve ayrılma ve ayrılma yerlerini dikkate alan uygun cerrahi planlama zorlu vakalarda başarıya yardımcı olabilmektedir.

Anahtar Kelimeler

Avülzyon, Dudak, Kedi, Serklaj Teli, Symphysis Mandibula Ayrılması, Avulsion, Cat, Cerclage Wire, Lip, Symphysis Mandibula Separation

Kaynakça

• Rhee S., Colville C., Buchman S.: Conservative management of large avulsions of the lip and local landmarks. Pediatr. Emerg. Care. 2004, 20: 40–2.
• Pope E.R.: Head and facial wounds in dogs and cats. Veterinary Clin. North Am. Small Anim. Pract. 2006, 36: 793-817.
• White T.: Lip avulsion and mandibular symphyseal separation repair in an immature cat. J. Vent. Dent. 2010, 27: 228–33.
• Akin I., Sarierler M., Kilic N., Belge A.: Multiple jaw fractures and hiatus linguae in a dog. Turkish J. Vet. Anim. Sci. 2013, 37(1): 117-120.
• Daraei P, Calligas J, Katz E, Etra J.W., Sethna A.B.: Reconstruction of upper lip avulsion after dog bite: case report and review of literature. Am. J. Otolaryngol. 2014, 35: 219–25.
• Vicari E., Stepaniuk K.: Step-by-step: mandibular lip avulsion repair in the dog and cat. J. Vet. Dent. 2014, 31: 212–7.
• Saverino K.M., Reiter A.M.: Clinical Presentation, Causes, Treatment, and Outcome of Lip Avulsion Injuries in Dogs and Cats: 24 Cases (2001–2017). Front. Vet. Sci. 2018, 5: 144.
• Pavletic M.: Reconstructive surgery of the lips and cheek. Veterinary Clin. North Am. Small Anim. Pract. 1990, 20: 201–26.
• Evans H., de Lahunta A.: Miller’s Anatomy of the Dog. 4th ed. Saunders, Elsevier, St. Louis, United States, 2013.
• Glyde M., Lidbetter D.: Management of fractures of the mandible in small animals. Practice. 2003, 25: 570–585.
• Farrow C.: Surgical treatment of lower-lip avulsion in the cat. Vet. Med. Small Animal Clin. 1973, 68: 1418–9.
• Verstraete F.J.M.: Maxillofacial fractures. In: Slatter D. Editor, Textbook of Small Animal Surgery. 3rd ed. WB Saunders, Philedelphia, United States, 2003, pp: 2190-2207.
• Reiter A., Lewis J.R.: Trauma-associated musculoskeletal injury to the head. In: Drobatz K.J., Beal M.W., Syring R.S., Editors, Manual of Trauma Management in the Dog and Cat, Willey-Blackwell, Delhi, India, 2011, pp.: 255–292.
• Swaim S.F.: Facial soft tissue injuries. In: Verstraete F.J., Lommer M.L., Editors, Oral and Maxillofacial Surgery in Dogs and Cats. Saunders, Elsevier, Edinburgh, United Kingdom, 2012, pp: 243–57.
• Domnick E.D.: Suture material and needle options in oral and periodontal surgery. J Vet. Dent. 2014, 31: 204–11.
• Colmery B.H., Hale F.A., Hoffman S.L., Johnston N.W., Kuntsi-Vaattovaara H., Reiter A.M.: Concern about dental trauma after invasive jaw fracture repair. J. Small Anim. Pract. 2011, 52: 448–449.
• Woodbridge N, Owen M.: Feline mandibular fractures a significant surgical challenge. J. Feline Med. Surg. 2013, 15: 211-218.
• Lobprise H., Dodd J.R.: Wiggs’s Veterinary Dentistry, 2nd ed. Willey-Blackwell, Hoboken, New Jersey, United States, 2019.
• Lombardero M., Alonso-Peñarando D., Yllera M.M.: The cat mandible (I): Anatomical basis to avoid iatrogenic damage in veterinary clinical practice. Animals. 2021, 11: 405.