Outcomes of surgical repair of congenital palatal defects in dogs

Peralta, Santiago; Campbell, Robert D.; Fiani, Nadine; Kan-Rohrer, Kimi H.; Verstraete, Frank J.M.

doi:10.2460/javma.253.11.1445

Cited by 14 publications

(27 citation statements)

References 22 publications

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“…Orofacial clefts in dogs are recognized shortly after birth based on signs observed by the breeder or clinician (e.g., drainage of milk from the nares during or after nursing; gagging, coughing or sneezing while eating) and visual examination [2, 9]. Surviving animals usually require nutritional support and palliative care until surgical repair can be performed at a later age [10, 11]. Cleft repair is technically complex, often requires multiple surgeries and is usually exclusive to specialized referral centers [10, 11].…”

Section: Introductionmentioning

confidence: 99%

“…Surviving animals usually require nutritional support and palliative care until surgical repair can be performed at a later age [10, 11]. Cleft repair is technically complex, often requires multiple surgeries and is usually exclusive to specialized referral centers [10, 11]. Therefore, the loss of animals due to medical complications or euthanasia (or the associated cost of nursing and surgical repair) represents a potentially substantial financial burden to breeders.…”

Section: Introductionmentioning

confidence: 99%

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Incidence patterns of orofacial clefts in purebred dogs

et al. 2019

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Cleft lip (CL), cleft palate (CP) and cleft lip and palate (CLP) are the most common types of orofacial clefts in dogs. Orofacial clefts in dogs are clinically relevant because of the associated morbidity and high newborn mortality rate and are of interest as comparative models of disease. However, the incidence of CL, CP and CLP has not been investigated in purebred dogs, and the financial impact on breeders is unknown. The aims of this study were to document the incidence patterns of CL, CP and CLP in different breeds of dogs, determine whether defect phenotype is associated with skull type, genetic cluster and geographic location, and estimate the financial impact in breeding programs in the United States by means of an anonymous online survey. A total of 228 orofacial clefts were reported among 7,429 puppies whelped in the 12 preceding months. Breeds in the mastiff/terrier genetic cluster and brachycephalic breeds were predisposed to orofacial clefts. Certain breeds in the ancient genetic cluster were at increased odds of orofacial clefts. Male purebred dogs were at increased odds of CPs. Results confirm that brachycephalic breeds are overrepresented among cases of orofacial clefts. Furthermore, geographic region appeared to be a relevant risk factor and orofacial clefts represented a considerable financial loss to breeders. Improved understanding of the epidemiology of orofacial clefts (frequency, causes, predictors and risk factors) may help in identifying ways to minimize their occurrence. Information gained may potentially help veterinarians and researchers to diagnose, treat and prevent orofacial clefts.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Incidence patterns of orofacial clefts in purebred dogs

et al. 2019

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“…Discussing the plan for staged procedures with the owner prior to embarking on a multiprocedure journey is essential to manage owner expectations. 13,22,23 We believe that this staged mandibular lip flap provides a useful option for closure after maxillectomy dehiscence. This technique provided a good functional outcome in this case by successfully covering the large palatal defect while also providing acceptable cosmesis.…”

Section: Discussionmentioning

confidence: 93%

“…Pedicle transection also facilitated normal occlusion and improved cosmesis. Discussing the plan for staged procedures with the owner prior to embarking on a multiprocedure journey is essential to manage owner expectations 13,22,23 …”

Section: Discussionmentioning

confidence: 99%

Staged mandibular lip flap for closure of a large palatal defect after maxillectomy in a dog

et al. 2021

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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.

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“…Long-term outcomes of various approaches are unknown until the patient is at least 18 years old and craniofacial growth is complete. The clefts of young dogs born with CP can be repaired using postnatal surgical approaches used for human babies and with comparable results (Bardach and Kelly, 1988; Peralta et al, 2018). Moreover, the dog is useful as a clinical model to test new approaches to surgical repair (Martinez-Alvarez et al, 2013; Paradas-Lara et al, 2014) and has the obvious advantage of achieving full maturity within 2 years rather than 2 decades.…”

Section: Discussionmentioning

confidence: 99%

Secondary Palate Development in the Dog (Canis lupus familiaris)

Freiberger

Hemker

McAnally

et al. 2020

The Cleft Palate-Craniofacial Journal

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Objective: To investigate the gestational timing of morphologic events in normal canine secondary palate development as a baseline for studies in dog models of isolated cleft palate (CP). Methods: Beagle and beagle/cocker spaniel-hybrid fetal dogs were obtained by cesarean-section on various days of gestation, timed from the initial rise of serum progesterone concentration. Morphology of fetal heads was determined by examining serial coronal sections. Results: On gestational day 35 (d35), the palatal shelves pointed ventrally alongside the tongue. On d36, palatal shelves were elongated and elevated to a horizontal position above the tongue but were not touching. On d37, palatine shelves and vomer were touching, but the medial epithelial seam (MES) between the apposed shelves remained. Immunostaining with epithelial protein markers showed that the MES gradually dissolved and was replaced by mesenchyme during d37-d44, and palate fusion was complete by d44. Examination of remnant MES suggested that fusion of palatal shelves began in mid-palate and moved rostrally and caudally. Conclusion: Palate development occurs in dogs in the steps described in humans and mice, but palate closure occurs at an intermediate time in gestation. These normative data will form the basis of future studies to determine pathophysiologic mechanisms in dog models of CP. Added clinical significance is the enhancement of dogs as a large animal model to test new approaches for palate repair, with the obvious advantage of achieving full maturity within 2 years rather than 2 decades.

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Outcomes of surgical repair of congenital palatal defects in dogs

Cited by 14 publications

References 22 publications

Incidence patterns of orofacial clefts in purebred dogs

Incidence patterns of orofacial clefts in purebred dogs

Staged mandibular lip flap for closure of a large palatal defect after maxillectomy in a dog

Secondary Palate Development in the Dog (Canis lupus familiaris)

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