Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse.
Abstract: To report use of mandibular condylectomy for treatment of advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. Methods: Clinical case report. Methods: Two-year-old Noriker filly. Methods: Computed tomography (CT) was used to confirm advanced degenerative joint disease of the left TMJ and for follow-up after mandibular condylectomy and removal of necrotic meniscus. Results: Painful swelling (3 weeks duration) with drainage located just caudal to the left lateral canthus of the eye was associated with atrophy of the left masseter muscle, masticatory problems, and inappetence. There was incisor malocclusion with a 1.4 cm resting lateral mandibular deviation to the right and inability to open the mouth more than a few centimeters. Left mandibular condylectomy combined with meniscectomy and thorough debridement of the septic left TMJ resulted in resolution of clinical signs and complete return of function. Streptococcus zooepidemicus, intermediately resistant to penicillin and subsequently to enrofloxacin, was isolated from the wound. Regeneration of a mandibular "pseudocondyle" was evident on CT at 4 months. At 4 months and 1 year the filly had maximal mouth opening >10 cm and no malocclusion. Conclusions: Mandibular condylectomy can be used to facilitate management of septic TMJ arthritis. There was no radiologic or clinical evidence of TMJ ankylosis >1 year after meniscal removal. Conclusions: Mandibular condylectomy, including meniscectomy, is an acceptable treatment option for advanced TMJ septic arthritis and allowed return of normal masticatory function.
Publication Date: 2006-10-10 PubMed ID: 17026552DOI: 10.1111/j.1532-950X.2006.00205.xGoogle Scholar: Lookup
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Summary
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This research is a clinical case study of a two-year-old Noriker filly (a young female horse of a particular breed) suffering from advanced degenerative joint disease of the temporomandibular joint (TMJ) caused by sepsis. The study finds that mandibular condylectomy (surgical removal of part of the mandible or lower jaw), in conjunction with meniscectomy and thorough debridement, was able to successfully treat the disease, resulting in the resolution of clinical symptoms and full restoration of function.
Introduction and Case Presentation
- The subject of this study was a two-year-old Noriker filly presenting with painful swelling and drainage near her eye, muscle atrophy, mastication issues, and a lack of appetite. Radiographic and clinical examinations revealed advanced degenerative joint disease of the temporomandibular joint, likely initiated by sepsis.
- Other symptoms included a malocclusion, a 1.4 cm resting lateral mandible deviation to the right and an inability to fully open the mouth.
Procedure and Results
- The horse underwent a mandibular condylectomy and meniscectomy, with thorough debridement of the joint to remove necrotic (dead) tissue.
- These procedures successfully alleviated the filly’s symptoms and restored normal eating and mastication behaviors.
- The bacterium Streptococcus zooepidemicus, moderately resistant to penicillin and later to enrofloxacin, was isolated from the wound.
- Follow-up examinations after the surgery, including computed tomography (CT) scans, showed the regeneration of a “pseudocondyle” – a substitute joint structure – at the operation site.
- Four months and one year after surgery, the filly was able to open her mouth more than 10 cm wide without malocclusion.
Conclusion
- The study concludes that mandibular condylectomy, combined with meniscectomy, can be an effective treatment for advanced septic arthritis in the TMJ, even in cases complicated by antimicrobial resistance.
- There were no signs of TMJ ankylosis (joint stiffness) or other complications more than a year after meniscal removal, suggesting that the treatment was long-lasting and effective.
Cite This Article
APA
Nagy AD, Simhofer H.
(2006).
Mandibular condylectomy and meniscectomy for the treatment of septic temporomandibular joint arthritis in a horse.
Vet Surg, 35(7), 663-668.
https://doi.org/10.1111/j.1532-950X.2006.00205.x Publication
Researcher Affiliations
- Clinic for Surgery and Ophthalmology, Equine Department, University of Veterinary Medicine, Vienna, Austria. adnagy@vt.edu
MeSH Terms
- Animals
- Arthritis, Infectious / microbiology
- Arthritis, Infectious / surgery
- Arthritis, Infectious / veterinary
- Arthroscopy / methods
- Arthroscopy / veterinary
- Debridement / methods
- Debridement / veterinary
- Female
- Horse Diseases / microbiology
- Horse Diseases / surgery
- Horses
- Mandibular Condyle / surgery
- Mastication / physiology
- Streptococcal Infections / surgery
- Streptococcal Infections / veterinary
- Streptococcus equi / isolation & purification
- Temporomandibular Joint Disorders / microbiology
- Temporomandibular Joint Disorders / surgery
- Temporomandibular Joint Disorders / veterinary
- Treatment Outcome
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