Notch Mandibulectomy in a German Shepherd Dog

Abstract

Case Description:<br><br> A one-year old castrated male German Shepherd dog, weighting 23.5 Kg was subjected for examination a mass in the mandible. The patient has no history of other diseases and was presented for a routine annual examination without any complaint of having problem for mastication, swallowing or salivation. <br><br><br><br>Treatment and outcome: <br><br> Physical examination was performed first and a single pink firm and non-ulcerated mass was observed on the gingiva in the central part of right mandible around the second premolar tooth. Fine needle aspiration was performed to be submitted for histologic examination. The case was diagnosed with fibromatous epulides. There were no signs of lymph node invasion although these tumors have no tendency to metastasize. Under general anesthesia with fully opened mouth and after surgical preparation of the oral cavity, the gingival mucosa behind the canine tooth was incised by electrosurgery for 3 cm length (Figures 1,2). Next six holes were drilled in to the mandible at the lower level of roots of the teeth (Figure 3). Osteotome was used to elevate the notch that is created in the mandible which holes was drilled in to it (Figure 4). A 3cm length of right mandible was resected with the technique called notch mandibulectomy and the mucosa was apposed. Post operative care include antibiotic and monitoring the surgical wound was performed and soft food supplied to the patient. The case was able to eat and drink normally two weeks after the operation without any complication . Long term follow up repoted no regrowth of tumor in other parts of oral tissues with excellent prognosis.<br><br><br><br>Discussion: <br><br> German Shepherd and other large breeds of dogs (more than 20 kg) have higher incidence of oral tumors and males are two times more affected than females. Epulides are the most common benign oral tumors in dogs that has three types. Fibroumatose epulides are originated from the gingival sulcus and the primary cell type is periodontal ligament stoma. Mandibulectomy is mostly performed for resection of oral tumors. Occasionally mandibular neoplasm also is treated by partial mandibulectomy which is most of the times, time consuming, heavily bleeding and tough surgery. Notch mandibulectomy is one of the means of partial mandibulectyomy that makes surgical resection of tumor more easier, lower duration of surgery and there is no need to disarticulate the mandible that involves more surgical manure. This technique is recommended for those oral tumors that are not invasive and does not need wide surgical excision. In addition adjunct radiotherapy is useful for tumors with high rate of recurrence.