Ch 88 Salivary glands Flashcards

Question

Where do sialoliths most commonly occur? | demonstrate a swelling on the lateral aspect of the face

Answer 1

Parotid duct | composition: calcium oxalate, phosphate, magnesium, or nonmineral

Answer 2

Surgical removal of effected duct-gland complex Incision through oral mucosa directly over stone Resection and anastomosis of duct Marsupialisation of dilated duct

Answer 3

Mandibular and parotid glands most commonly effected Adenocarcinoma and acinic carcinoma most common LN involvement in 17% dogs and 39% cats

Answer 4

- staging recommended > prognosis is not correlated with histologic grade but is associated with stage of disease - owner to understand whether the procedure is being performed for diagnosis, cytoreduction, palliation, curative intent, prevention, or metastasectomy - Sentinel lymph node extirpation can be performed - prognosis is largely unknown

Answer 5

- ventral approach permits removal of the entire sublingual gland-duct complex compared to lateral Ventral Approach - platysma muscle is incised to facilitate identification of the external jugular bifurcation; the mandibular gland sits at or just cranial to this bifurcation - The capsule over both glands is incised and bluntly dissected, vessels on the medial side ligated - The gland complex retracted caudally to allow blunt dissection of the sublingual gland under the digastricus muscle. - hemostat placed from rostral to caudal under the digastricus muscle, the glands are excised - remaining ducts and sublingual glands are pulled under the digastricus muscle, dissection are continued to the level of the lingual nerve (the mylohyoideus muscle is incised for best exposure) - If a ranula is present, however, dissection should continue rostral to the lingual nerve under the mylohyoideus to the sublingual caruncle - incisional drainage of the sialocoele with or without drain placement

Answer 6

- aponeurosis of the masseter muscle is reflected off of the ventral aspect of the zygomatic arch, and the orbital fascia is reflected dorsally. - portion of the arch is removed, as necessary, with a bone saw - Orbital fat is dissected and retracted - gland resides medial to the zygomatic arch and adjacent to the globe -

Answer 7

- facial nerve paresis or paralysis is a common complication. - starting at a point below the external acoustic meatus and extending ventrally - platysma and parotidoauricularis muscles are incised - ligation and division of the caudal auricular vein, the parotid gland is bluntly dissected -

Answer 8

1. Intralesional injections of sclerosing agents (polidocanol) successfully used for orbital mucocele 2. radiation therapy 3. N-acetylcysteine (gland preserving) 4. medical antibiotics and nsaid

Answer 9

Dissection and removal of accessory parotid gland just dorsal to the parotid duct

Answer 10

Retrospective. 72. surgically excised canine salivary gland carcinoma The overall (MST) was 1886 days. recurrence (42%), overall (DFI) of 191 days. Metastatic disease occurred in (31.9%) dogs node metastasis present (28.9%) dogs > lymphadenectomy; these dogs had a shorter MST at 248 days Nodal metastasis was a negative prognostic factor Thirty-four dogs received adjuvant therapy following surgery. Chemotherapy, radiation or nonsteroidal antiinflammatory The perioperative complication rate was 23.6%: facial nerve injury 10% and swelling or seroma formation

Answer 11

Intraoral approach for zygomatic sialoadenectomy. Cadaver and 3 cases. compare this surgical approach to a modified lateral orbitotomy Removal of the ZSG was complete in 8/10 and 10/10 dogs using the IOA and LOA, respectively case series had no complications. salivary duct catheterised and injected with methylene blue. IOA: reduced surgical time, no preoperative clipping was necessary and less tissue dissection was needed. minimizing invasiveness of the approach. Need to compare different techniques clinically.

Answer 12

Methylene blue was either administered via cannulation of the parotid duct or directly injected into the abnormal gland. R esults: In all cases, the gland stained dark blue within seconds without any evident leakage. Complete parotid gland resection and removal of the parotid duct was achieved successfully in all dogs Subjectively, the staining was useful to identify innervation outside the coloured gland and facilitated dissection

Answer 13

59 samples of oral melanomas significant relationship was identified between the size of oral melanomas and a single variable of histologic grade, lymphatic invasion, lymphatic invasion can confidently be ruled out for tumors < 0.65 cm in diameter (100% sensitivity) and ruled in for tumors ≥ 2.45 cm in diameter (100% specificity). Lymphatic invasion has been described as the gold standard for identification of malignancy invasion is negatively associated with patient survival in dogs with oral melanomas. Of the 52 melanomas investigated, a significant (P = 0.014) difference was observed in the MST of dogs with (7.3 months) and without (10.5 months) lymphatic invasion.

Answer 14

may cause obstruction of airway Surgical deroofing of the sialoceles was performed under endoscopic guidance with biopsy forceps in 5 cases and by diode laser in 6 cases. No recurrence was diagnosed chronic nonphysiologic mechanical stress causing changes in minor nasopharyngeal salivary glands. Direct visualization by nasopharyngoscopy is the best technique for detection of NPS,

Answer 15

Cadaveric. Comparison of three surgical approaches for zygomatic sialoadenectomy lateral + ostectomy vs without ostectomy + ventral or dorsal to the zygomatic arch. Ostectomy > excellent surgical view and good exposure with more tissue trauma. Dorsal nonostectomy > not allow complete gland extraction, relatively blind dissection ventral nonostectomy approach enabled complete extraction in all 10 dogs. zygomatic gland crossed by a branch of the deep facial vein.

Answer 16

retrospective (no control group) Intracanalicular injection of 10% N-acetylcysteine. 25 dogs. The zygomatic gland > [92%] dogs, most considered idiopathic performed with local anesthesia, + ab’s and NSAID recurrence [22%] dogs, all managed medically. N-acetylcysteine, a cysteine prodrug and glutathione precursor = mucolytic and antioxidant agent. Expect disruption of thick salivary secretions > aim to preserve function of gland (vs surgical removal) could have a role as a first therapeutic approach >, potentially reducing the need for surgical intervention

Answer 17

Five were treated after surgical excision of the primary tumour, but four had gross disease (primary or metastatic) at the time of starting radiotherapy. No cat died as a result of distant metastatic disease. Survival time was known for three cats (55 days, 258 days and 570 days 5 cats also recieved chemo RT side effects were very mild: all cats had VRTOG grade 1 toxicity at the end of therapy surgery and radiotherapy is superior to radiotherapy alone. However, the benefits of postoperative radiotherapy compared with surgery alone are only clear in patients with high-risk tumours (ie, those with large and invasive primary tumours, close or incomplete margins, high histopathological grade, histological evidence of neural or vascular invasion, or positive lymph nodes). This radiation therapy may help improve locoregional control and survival in cats

Answer 18

Retrospective. surgically treated sialoceles in 21 cats dysphagia and ptyalism + rannula Surgical = sialoadenectomy and/or marsupialization (4 cats). Intraoperative complications 3 cats (mandibular lymph node inadvertently removed), postoperative 5 cats. resolution of clinical signs in all cats. No recurrence > follow-up period (30–968 days). sublingual and mandibular most commonly affected. post-op complications: 23.8% higher than canine retrospective studies (15%). swelling Over half of the cats in the current study had undergone previous drainage of the sialocele The aetiology: traumatic 2, neoplastic 1 and unknown in most

Answer 19

caudal labial masses. Curative intent surgery was performed in three cats, whereas palliative surgery (debulking) owing to extensive soft tissue invasion was performed in one cat. Survival times were in the range of 210–1730 (mean 787) days. All four cats were euthanized owing to local recurrence and decreased quality of life, regardless of treatment modality. propose that early aggressive surgical treatment with wide surgical margins should be performed for cats with salivary gland adenocarcinoma of minor salivary gland origin. Surgery increased the quality and duration of life

Answer 20

Salivary duct ectasia, defined as dilation of the salivary duct, has been rarely reported in veterinary literature Fourteen dogs were included. Lateral facial swelling was the most common clinical presentation. CT revealed a tortuous cavitary tubular fluid-filled structure consistent Surgical treatment included marsupialisation of the parotid duct papilla, surgical exploration of the duct alone, parotid duct marsupialisation with surgical exploration of the duct, parotidectomy or en-bloc parotid duct resection No recurrence of clinical signs was noted during the follow-up period (range 21 to 2900 days The treatment method should be selected based on the location of the stricture and the extent of the ductal dilation. If the stricture is present near the parotid duct orifice or in the parotid duct near the oral cavity, reimplantation or marsupialisation represent two valid options (Baurmash, 2007; Han et al., 2020; Yoon et al., 2009). Whereas if the obstruction is near the parotid gland, parotidectomy or duct ligation are preferable In the authors’ opinion, parotidectomy should be reserved for animals where the aetiology or diagnostic imaging findings indicate that main lesion is in, or close to, the parotid gland, as it carries a high risk of facial or trigeminal nerve injury

Answer 21

- ventral and lateral approaches for mandibular/sublingual sialoadenectomy, n=140 complications: lateral 20%, ventral 31% - no difference in incidence; overall 24% - recurrence more likely after lateral approach and with prolonged sx - wound-related complications more likely after ventral approach

Ch 88 Salivary glands Flashcards

(45 cards)