Volume 36 | Issue 3 Article 2

1974 Mandibular Sialoadenectomy Thomas Juergens Iowa State University

Gene K. Hjelm Iowa State University

Randall L. Lange Iowa State University

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Recommended Citation Juergens, Thomas; Hjelm, Gene K.; and Lange, Randall L. (1974) "Mandibular Sialoadenectomy," Iowa State University Veterinarian: Vol. 36 : Iss. 3 , Article 2. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol36/iss3/2

This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. phosphorous, and essential mineral ele­ Bibliography ments. As an energy source, the value of 1. Conch, J. R. Evaluation of Poultry Manure as a Feed recycled wastes would be of limited value; Ingredient. ANRC paper. Feedstuffs, Mar. 25, 1974, Vol. 46, No. 12. however, it may be of some value in a 2. Poterot, J. P. and K. E. Webb. The Value of Animal situation of roughage replacement. Two Wastes as Feeds for Ruminants. ANRC paper. Feed­ other related advantages would be pollu­ stuffs, Apr. 8, 1974, Vol. 406, No. 14. 3. Harmon, B. G. Potential for Recycling Swine Wastes. tion control and waste disposal. ANRC paper. Feedstuffs, Mar. 4, 1974, Vol. 46, No.9. There are many disadvantages at the 4. National Research Council. Nutrient Requirements of Swine, Washington, D.C., Printing and Publishing present time but with research and ex­ Office, National Academy of Sciences, 1968, page 37. perience, recycling will certainly prove to 5. Vetter, R. L. Recycling, it's problems and opportuni­ ties, Paper presented at Beef in Confinement Workshop have economic value. As stated in the (NFIA), April 4,1974. article, cooperation among animal science 6. Vetter, R. L. and R. D. Christensen. 1972. }'eeding value of processed animal waste nutrients from a cattle people, nutritionists, and veterinarians confinement oxidation ditch system. Iowa Cattle Feed­ will ,certainly be beneficial in implement­ ers Report., A. S. Leaflet 170. 7. Vetter, R. L. and R. D. Christensen. 1973. Iteeding ing recycling. value of processed animal waste nutrients frOln a cattle In regard to disease control and making confinement oxidation ditch system. Iowa Cattle Feed­ ers Report., A. S. Leaflet 182. recycling available to the smaller opera­ 8. Vetter, R. L. and Wise Burroughs. 1974. Nutritive tions, veterinarians have an excellent op­ value of cattle excreta ensiled and fed to feedlot cattle prior to the final finishing period. Iowa Cattle :Feed­ portunity to be of service. ers Report., A. S. Leaflet 195.

Mandibular Sialoadenectomy

by Thomas Juergens* Gene K. Hjelm Randall L. Lange

The two indications for a sialoadenec­ ferent causes. It can be due to trauma to tomy are in cases where there is either a the head and neck, oftentimes due to bite sialocele (cervical cyst or wounds. Or the may spread a.s mucocele) or a where medical an ascending infection from the mouth, treatment has not been successful. These or it could be as a result of a migrating two condition:s will be discussed in depth foreign,object.7 separately. The glands miost commonly infected are the zygomatic, parotid and mandibu­ Sialadenitis lar gland,s. The clinical signs associated with a Sialadenitis is an inflarnm,ation of the sialadenitis would be a swelling over the salivary glands. This condition is rare in gland region with a corresponding in­ dogs and cats, as the salivary glands rare­ crease in body te.mperature. Also noted ly become infected. would be pain when the animal eats.3 If Sialadenitis can be due to several dif- the zygomatic gland were involved, there would be a characteristic swelling of the -The authors are fourth year students in the College of Veterinary Medicine. Iowa State University. eye region.

94 Iowa State University Veterinarian Non-surgical treatment is first attempt­ used. Aspiration of contents will aid in ed. This would include letting the abscess diagnosis. Also, sialography can be uti­ mature, then lancing it. Follow this up lized. This is accomplished by infusing with systemic antibiotics. It will take 7­ six to ten c.c. of radio-opaque solution up 10 days for the healing to begin. The the duct. However, oftentimes the only healing must occur from inside to out. way to diagnose is to excise the involved gland. Sialocele (cervical salivary cyst) There is no medical treatment for this condition. We do not lance or inject drugs The characteristic symptoms associated or 'sclerosing agents, as response to these with a cervical salivary cyst are a gradual is only temporary and it makes later surg­ fluctuating swelling over the gland re­ ery much more difficult.7 gion; usually this swelling begins unilater­ Occasionally associated with a sialocele ally. At this time a may be present. is a ranula, which is a transparent, fluc­ Contents are often initially clear but later tuating cyst on the floor of the mouth. The may be blood-tinged to bloody or extreme­ probable cause of this condition is trauma ly mucoid to gelatinous.3•7 by a foreign body or contusion to papilla, In chronic stages, an inflammatory re­ ducts or sublingual glands.7 sponse to the is seen. An extensive Recommended treatment for this condi­ granulation tissue-lined connective tissue tion is marsupialization of the ranula. Ex­ sac is found within the cyst itself, and cise the roof of the cyst and evacuate the contains many 'sialoliths. The etiology of contents. Suture the base of the cyst to a sialocele is most often trauma, especial­ normal adjoining mucous membrane with ly a contusion.7 Sialoliths occur usually catgut. If this condition persists, removal after the gland or duct has ruptured.3 of the mandibular and sublingual glands For diagnosis, several methods can be is indicated.5

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Figure 1. Salivary glands (from Millers Guide to the Dissection uf the Dog)

Issue No.3, 1974 95 t. , ,,\ ... ~___~ --J

Figure 2. Site of incision (from Fundamentals of Small Animal Surgery by Leonard)

If medical treatment fails for the pre­ B. The zygomatic salivary gland is a well viously discussed conditions, surgical re­ lobulated mass located in the rostral part moval of the gland is necessary. Occasion­ of the pterygoid fossa. The duct's papilla ally a recurrent cervical sialocele occurs. is ventral and slightly caudal to the paro­ If there is no improvement after seven tid duct opening near the last upper mo­ days, removal of the gland on the oppo­ lar. site side is indicated. There have been C. The mandibular salivary gland lies cases in which the glands on the opposite largely between the external and internal side became involved or were concurrent­ maxillary veins just posterior to the angle ly involved at the time of surgery. Resec­ of the jaw. The mandibular gland and a tion of bilateral sets of salivary glands portion of the sublingual gland are con­ does not result in "dry mouth," contrary to tained within a heavy fibrous capsule. The what many people think.1,7 mandibular duct leaves the medial surface Surgical Anatomy (Fig. 1) of the gland and runs anterio-medially ly­ The dog has four paired salivary glands, ing in close relation to the medial aspect all opening into the oral cavity. of the sublingual glands. The arterial supply to the mandibular A. The is a pale, loosely gland is mainly by the glandular branch lobulated gland lying mainly at the base of the ear. Its ventral aspect extends over of the facial artery and enters the gland the dorso-Iateral surface of the mandibular where the duct leaves it. Along the dorsal salivary gland. The parotid duct crosses surface of the gland enter some small the superficial face of the masseter muscle branches of the auricular artery. The and enters the mouth opposite the upper venous drainage is mainly to the lingual fourth premolar. veins and then to the external maxillary.

96 Iowa State University Veterinarian D. The sublingual gland is an aggrega­ my) is as follows for treatment of a cervi­ tion of two to four masses extending along cal salivary cyst. the mandibular duct which extends an­ The mandibular and/or sublingual teriomedially between the masseter muscle glands are those most often seen clinical­ and the digastric muscle. A separate por­ ly as cyst producing, thus the surgery will tion of the sublingual glands lies under be directed at removal of these glands. the mucosa extending from ,the jaw to the Under general anesthesia, the patient is tongue. They are very small and enter the placed in dorsal lateral recumbency and main sublingual duct. The sublingual duct draped such that a six to eight em. longi­ and mandibular duct course together be­ tudinal incision may be made caudally tween the genioglossal and mylohyoid from the bifurcation of the external jugu­ muscles. In two-thirds of the dogs separ­ lar vein and extending rostrally. (Fig. 2) ate openings of the two glands are seen The incision is made in a rostral to caud­ with the mandibular papilla lying anterior al direction. The fibers of the platysma to the sublingual papilla at the anterior muscle are separated with a scissors, but edge of the frenulum near the symphysis many times this step is not necessary as of the . The arterial supply to the fibers of the platysma run in the same the sublingual glands is via the glandular general direction as the skin incision. In portion of the facial artery. certain cases, the depressor auricularis muscle may need to be incised to assure The lymphatic drainage of the man­ adequate exposure of the mandibular dibular and sublingual glands is to the gland. These two muscles are very thin medial retropharyngeal lymph nodes.2,6 and incised easily. After exposure of the mandibular gland Surgical Procedure capsule, it is incised. The glandular tissue The surgical procedure to remove the is bluntly dissected from the capsular affected salivary glandes) (sialoadenecto- wall. The blood supply on the medial sur-

Figure 3. Lateral·medial sialograph of mandibular salivary gland

Issue No.3, 19-74 97 Figure 4. Ventral-dorsal sialograph of mandibular salivary gland.

face of the gland is ligated before further placed on the neck covering the incision removal. The mandibular gland is then site and area of redundant skin. An anti­ gently lifted from the capsule and the duct biotic/corticD-steroid preparation is indi­ is bluntly dissected free as it passes ros­ cated for three to four days. Drainage trally. The sublingual salivary glands will tubes should be pulled when active drain­ come into view as the dissection proceeds. ing ceases, usually around four to five When the chain of sublingual glands are days. Occasionally extensive swelling ap­ freed from adjacent fissues, a ligature is pears at around 48 hours. Modera'te com­ placed around the salivary duct, .as far pression bandaging, diuretics and cortico­ rostral as possible and will usually be just steroid therapy will usually relieve medial to the ramus of the . The signs.1,5,7 duct is ,then transected caudal to the liga­ ture and the mandibular and 'sublingual Bibliography glands are removed. The dead spaces are closed with 2-0 I. Archibald, James, Canine Surgery, First Archibald Edi· tion, Santa Barbara, California, American Veterinary chromic catgut. As much as possible of Publications, Inc., 1965, pp. 373-378. the cystic sac and redundant skin is re­ 2. Evans, Howard E. and deLaHunta, Alexander, Miller's Guide to the Dissection 0/ the Dog, Philadelphia, W. B. 'sected. A drainage tube is inserted and the Saunders Co., 1971, p. 103. 3. Glen, J. B., Canine salivary mucocoeles, J. Small Anim. skin is closed around the tube, by a simple Pract., 15:515-526, 1972. 4. Knecht, C. D. and Joyce Phares, Characterization of interrupted pattern of fine non-absorbable dogs with salivary cyst, JAVMA, 158(5):612, 1971. suture material.I ,5,7 5. Leonard, Ellis P., Fundamentals 0/ Small Animal Surg. ery, Philadelphia, W. B. Saunders Co., 1968, pp. 178­ 180. 6. Miller, M. E.: Christensen, G. C.; Evans, H. E., An. Post-Operative Care atomy 0/ the Dog, Philadelphia, W. B. Saunders Co., 1964, pp. 65tHi60. 7. Spreull, J. S. A. and K. W. Head, Cervical salivary cysts A moderate compression bandage is in tbe dog, J. Small Anim. Pract., 8:17-35, 1967.

98 Iowa State University Veterina'nan