Commissurotomy Using Carbon Dioxide Laser in 67 Dogs

Area of Science:

• Veterinary Surgery
• Oral and Maxillofacial Surgery
• Surgical Oncology

Background:

• Commissurotomy is a surgical incision of the lip commissure.
• Indications include cheiloplasty, partial commissurectomy, or surgical access to the maxilla/mandible.
• Oral and maxillofacial neoplasms in dogs often require resective surgery, potentially involving the lip commissure.

Purpose of the Study:

• To evaluate the efficacy and complications of carbon dioxide (CO2) laser commissurotomy in dogs with oral or maxillofacial neoplasms.
• To assess the healing process and long-term outcomes of CO2 laser commissurotomy.

Main Methods:

• CO2 laser was used for commissurotomy or commissurectomy in 67 dogs with oral/maxillofacial neoplasms.
• Procedures included partial commissurectomy (n=7) and access for oral surgery (n=60).
• Healing was evaluated at 2 weeks, with a minimum follow-up of 6 weeks (mean 104.6 ± 99.2 weeks).

Main Results:

• Six postoperative complications related to commissurotomy were reported: 3 mucosal dehiscences (<1.5 cm), 2 lip margin dehiscences (<1.0 cm), and 1 complete wound dehiscence.
• Two cases of wound dehiscence, including the complete one, healed after revision surgery.
• Minor dehiscences healed by second intention, and periwound edema resolved by 2 weeks.
• Complications were independent of surgical procedure type, tumor type, and surgical margin evaluation.

Conclusions:

• CO2 laser commissurotomy provides rapid, unimpeded surgical exposure with minimal hemorrhage for resective oral and maxillofacial surgery in dogs.
• The technique is associated with a low complication rate, and complications are manageable.
• CO2 laser commissurotomy is a viable option for accessing the caudal maxilla and mandible in veterinary oral surgery.