Commissurotomy Using Carbon Dioxide Laser in 67 Dogs

Commissurotomy is a surgical technique whereby the lip commissure is incised. Indications for commissurotomy include cheiloplasty, partial commissurectomy, or access to the caudal portion of the maxilla or mandible for oral surgery. Carbon dioxide (CO₂) laser was used for commissurotomy in dogs for partial commissurectomy (n = 7) or access for oral surgery (n = 60). All dogs had oral or maxillofacial neoplasms that required resective surgery. The CO₂ laser was used to perform commissurotomy or commissurectomy, as indicated. Commissurotomy healing was evaluated at 2 weeks with longer-term follow-up of a minimum of 6 weeks (104.6 ± 99.2 weeks) postoperatively. Postoperative complications related to commissurotomy (n = 6) included mucosal dehiscence (n = 3) less than 1.5 cm, lip margin dehiscence (n = 2) less than 1.0 cm, and complete commissurotomy wound dehiscence (n = 1). Two wound dehiscence cases, including the complete wound dehiscence, had uncomplicated healing following revision surgery. Minor marginal and mucosal dehiscence cases healed by the second intention. Periwound edema ranged from mild to severe and resolved by the 2-week postoperative examination. Statistical analysis showed that complications associated with commissurotomy/commissurectomy were independent of the type of surgical procedure, tumor type, and surgical margin evaluation when using the CO₂ laser. Commissurotomy using CO₂ laser provided rapid and unimpeded exposure with minimal hemorrhage of the caudal maxilla and mandible for resective oral and maxillofacial surgery.