BILATERAL ROSTRAL MANDIBULECTOMY

Bilateral rostral mandibulectomy is a surgical procedure involving removal of the mandible rostral to the second premolar tooth. This technique is indicated for benign oral tumors, such as acanthomatous ameloblastoma and either small or low-grade malignant tumors, which have crossed the midline.

The overall complication rate following bilateral rostral mandibulectomy in dogs is 19%. The most common complications are wound dehiscence (2%-8%) and short-term eating difficulties (up to 44% overall with 30%, 70%, 90%, and 97% of dogs returning to voluntary eating by day 1, 2, 3, and 4, respectively). The median time to return to voluntary eating is 2 days following bilateral rostral mandibulectomy in dogs. In one study, prehension difficulties were common following bilateral rostral mandibulectomy, particularly with more aggressive procedures extending caudal to the second premolar teeth because of the loss of bone and soft tissue support of the tongue; however, the majority of dogs with prehension difficulties adapt within 2 weeks of surgery.

Complications are more frequently encountered in cats with 92% of cats having short-term complications and 50% of cats having long-term complications. The most common complications are eating difficulties and/or dysphagia, and this is seen in 84% of cats in the first 14 days after surgery and long-term in 10% of cats treated with bilateral rostral mandibulectomy. Ptyalism (excessive drooling) is reported in 50% of cats following bilateral rostral mandibulectomy and this was persistent in 30% of these cats. Grooming difficulties and tongue protrusion are reported in 17% and 33% of cats, respectively. Despite this high complication rate and need for supplemental nutrition via a feeding tube postoperatively, 83% of owners were satisfied with the outcome following mandibulectomy in their cats.