Oral Surgery

Question 1

In Bach 2014 paper “Bacterial Meningitis After Sinus Surgery in Five Adult Horses”, what was the onset of time to neurologic clinical signs from sinus surgery?

Vet Surg 2014

Answer 1

5–11 days after initial surgery and 4–11 days after last surgery in all 5 horses

Question 2

In Bach’s 2014 paper, “Bacterial Meningitis After Sinus Surgery in Five Adult Horses”, what were the 4 pathways hypothesized to have caused meningitis secondarily to sinus surgery?

Vet Surg 2014

Answer 2

1. osteitis/erosion of thin bones → fracture of cribiform plate
2. vascular spread (hematogenous‐metastatic, thrombophlebotic)
3. along cranial nerves (more common in ruminants - listeriosis), hypoth optic nerve in sphenopalatine sinus involvement
4. direct bacterial inoculation caused by (iatrogenic) head trauma

Question 3

In Mendez-Angulo’s paper “Extensive Rostral Mandibulectomy for Treatment of Ameloblastoma in a Horse” to what extent was the rostral mandibulectomy performed?

Vet Surg 2014

Answer 3

Caudal aspect of symphysis - The day after surgery, the remaining mandibular symphysis (<5 mm) fractured

Question 4

In Gilsenan’s case series “Headshaking in 5 Horses After Paranasal Sinus Surgery”, what dose of gabapentin was effective in resolution of clinical signs in 2/5 horses?

Vet Surg 2014

Answer 4

5–10 mg/kg orally every 6–8 hours

Question 5

What is the presumed MOA of neuropathic pain?

Gilsenan et al Vet Surg 2014

Answer 5

neuropathic pain are caused by spontaneous ectopic neuronal firing that may result from upregulation of sodium channels in injured nerves in various phases of repair

Question 6

In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what was the success rate of MITSE?

Answer 6

47/58

Question 7

In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what were the post-operative complications described by the authors?

Answer 7

• 4/58 (7%) animals w/ hemorrhage from trocar incision
• 3/58 procedures diffusion of local anesthetic caused temporary loss of facial nerve motor function
• 1/58 had oroantral communication

Question 8

In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” what was the most common intraoperative complication described by the authors?

Answer 8

Screw pullout

Mechanical lockage of the target tooth w/in the extraction path resulted in screw pullout in 13/32 procedures

Friable tooth material responsible for screw pullout in 19/32 procedures

Question 9

In the 2015 study by Langeneckert et al, “Cheek Tooth Extraction Via a Minimally Invasive Transbuccal Approach and Intradental Screw Placement in 54 Equids,” MITSE was found to be favorable when compared to repulsion and invasive lateral buccotomy techniques for which reasons?

Answer 9

Repulsion:
- 3/14 (21%) of horses w/ repulsion of mandibular CT developed chronic draining tracts
- 6/30 (20%) of horses w/ entire apical repulsion of maxillary CT developed chronic nasal discharge w/ or w/o oroantral fistula formation (Prichard et al., 1992)
-vs. 2/33 (6%) of animals in this study

Invasive lateral buccotomy techniques:
- 3/112 (3%) of horses developed prolonged or permanent paralysis of the ventral buccal ramus of the facial nerve w/ drooping of the lower lip observed more than 2 months after surgery (O’Neill et al., 2011)