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Staged mandibular lip flap for closure of a large palatal defect after maxillectomy in a dog
Aidan R Chambers1, Owen T Skinner1, Lauren A Reeves1
1Department of Veterinary Medicine and Surgery, University of Missouri, Columbia, Missouri.
Objective:
To report closure of an oronasal defect secondary to maxillectomy with a staged mandibular lip flap.
Study Design:
Case report ANIMALS: One 9-year-old female spayed golden retriever.
Methods:
A combined dorsolateral and intraoral approach was used to perform a central maxillectomy to excise a 2.4- × 2- × 2.7-cm oral osteosarcoma with 1-cm margins. A buccal mucosal flap was used to close the palatal defect but the site subsequently dehisced. A staged mandibular lip flap was performed to close the defect. An incision was made on the mandible at the intersection of the buccal mucosa and gingiva from the mandibular canine to the level of the commissure. A second incision was made 3 cm ventral to the lip margin. The flap pedicle was based at the commissure. The flap was rotated to cover the palatal defect from rostral to the canine tooth to the fourth premolar. A second procedure was performed 4 weeks after flap placement to desquamate the haired skin and transect the flap pedicle.
Results:
Partial dehiscence at the caudal aspect of the flap occurred after the first revision. The defect was closed after pedicle transection on day 41, with acceptable cosmesis. The dog was eating canned food with no evidence of discomfort 159 days after the maxillectomy. Recurrence was noted on day 270 postoperatively.
Conclusion:
Closure of a large palatal defect with a staged mandibular lip flap led to good cosmesis and function.
