Peer-reviewed veterinary case report
How tying off the maxillary artery reduces bleeding in dog jaw surgery
By Carroll, Kenneth A & Mathews, Kyle G·Published in Frontiers in veterinary science·2020·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Ligation of the Maxillary Artery Prior to Caudal Maxillectomy in the Dog-A Description of the Technique, Retrospective Evaluation of Blood Loss, and Cadaveric Evaluation of Maxillary Artery Anatomy.
- Species:
- dog
Plain-English summary
A group of 22 dogs undergoing surgery to remove tumors from the back of the mouth (caudal maxillectomy) was studied to see if tying off the maxillary artery beforehand would reduce bleeding. In the traditional surgery method, all six dogs experienced low blood pressure during the procedure, and four needed blood transfusions. However, in the modified method where the artery was tied off first, only one dog needed a transfusion, and just three had low blood pressure. This approach not only helped control bleeding but also improved the overall safety of the surgery.
People also search for: dog mouth tumor surgery · maxillectomy bleeding prevention · dog blood transfusion during surgery
Abstract
Two different surgical techniques have been described for performing caudal maxillectomies in dogs including the intraoral (IO) and combined dorsolateral and intraoral (DL-IO) approach. Hemorrhage is the most common intraoperative complication reported during these procedures as maxillary arterial ligation is not performed until after all osteotomies and mobilization of tumor-bearing bone. The objectives of this study were to describe a modified approach for caudal maxillectomy in the dog involving preligation of the maxillary artery, to retrospectively evaluate the ability of this modified approach to limit hemorrhage in a cohort of 22 dogs, and to clarify the vascular anatomy of the maxillary artery and its branches in relation to associated nerves. Medical records were retrospectively reviewed for cases that had caudal maxillectomy via a combined approach (with or without preligation of the maxillary artery) from January 1, 2004 to December 31, 2019. Twenty-two cases were identified, six without, and 16 with arterial preligation, respectively. Osteotomies were completed with a high-speed handpiece and rotary bur (= 18), or oscillating bone saw (= 4). All six (100%) dogs in the traditional DL-IO group developed hypotension under general anesthesia. Four (67%) of these required intraoperative blood transfusions, one of which required an additional postoperative blood transfusion. In contrast, only one of 16 (6%) dogs in the modified DL-IO group required an intraoperative blood transfusion, and only three (19%) developed hypotension. Moreover, a significant association was detected between postoperative PCV and the two different surgical approaches (= 0.021). These results demonstrate the effectiveness of preligation of the maxillary artery in preventing hemorrhage in caudal maxillectomies in dogs and this represents an improvement in outcome over previously reported studies. Decreased intraoperative hemorrhage may improve surgical exposure and decrease overall patient morbidity.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/33251269/