Successful sialoadenectomy to treat

cervical mucocoele associated with oral

mucocoele in dog

PDS Raghuvanshi, Raju Sharda, Manisha Jaiswal, Safdar

Ali khan, Jashwanth gowda BM

Abstract
Cervical mucocoele is a common type of mucocoele. It
is an accumulation of saliva in adjacent subcutaneous
tissue due to tear in salivary gland (Bellenger and
Simpson,1992). The inciting cause is not definitely
identified , though trauma from a choke chain, bites or
extensive scratching to the neck and sudden
hyperextension of the neck are the suspected cause
which may lead to tearing of the salivary gland or duct.
A 20months old Belgium shepherd dog belonging to
Chhattisgarh armed forces was presented to institute’s
teaching veterinary clinical complex with a history of
swelling in the ventral aspect of tongue and
inappetence .On physical examination, a swelling was
observed in the ventral aspect of neck as well as in the
sublingual area which was fluctuating in nature. On
FNAT of the swollen ;the aspirated content was straw
colored and mucinous in nature ,confirming the
presence of saliva. It was finally diagnosed as a case of
cervical mucocele along with an oral mucocoele
(ranula) .A successful surgical resection of sublingual
gland was done under general anaesthesia from
cervical region . The sublingual salivary cyst was
incised, partially dissected, deroofed and marsupialized
.The adjacent muscle and subcutaneous tissues were
sutured and skin was opposed in normal routine
fashion .The patient made an uneventful recovery after
post operative medication and dressing without any
complication.
Keywords: cervical mucocoele, ranula,
sialoadenectomy, marsupialization, dog.

Introduction
A salivary mucocoele or sialocoele is an abnormal
accumulation of saliva in the subcutaneous tissue
adjacent to a damaged salivary duct or gland (Hedlund
CS and Fossum,2007). Sublingual and mandibular
sialocoele are most common mucocoele. Aspiration
and drainage are usually inadequate are usually
inadequate as treatment options and are associated
with recurrence of mucocoele(Bellenger and Simpson ,
1992) : so it was recommended to surgically ablate the
gland along with duct. Hence, sublingual
sialoadenectomy was done to treat these idiopathic
cervical mucocoele in the presented dog.

Materials and Methods

A 20 months old Belgium shepherd dog from
Chhattisgarh armed forces was presented at TVCC with
an acute progressive swelling in the ventral inter-
mandibular region, dysphagia ,anorexia, ptyalism and
abnormal movement of tongue since last two weeks
.On physical examination dog had a fluctuating swelling
in the submandibular region. On applying digital
pressure the swelling was reduced and the swollen
mass migrated sublingually. Routine hematology and
serum biochemistry were almost within normal limits.
X-ray revealed, discrete radiodensity of fluid(saliva) in
submandibular area. A painless swelling was observed
on cranioventral aspect of neck and another was
observed in the ventral aspect of tongue close to the
base ,right deviation of tongue was observed. Based on
history and clinical findings, cervical mucocele
associated with oral mucocele (ranula) was suspected.
Paracentesis of swollen mass revealed presence of
mucinous ,ropy, straw-colored fluid confirming the
presence of saliva . Hence ,a genuine diagnosis of
cervical mucocele of left sublingual gland associated
with ranula was made. Drainage of the content was
inadequate to resolve the problem , so surgery was
planned to deroof the mucocoele, sialoadenectomy
followed by marsupialization of the sublingual gland .
Surgical treatment and discussion
The dog was premedicated with an intramuscular
inj.atropine sulphate @0.04mg/kg and inj.xylazine
@0.5mg/kg b.wt. Anaesthesia was achieved with a
combination of Zolazepam and tiletamine
@50mg/kgbwt, IV. The animal was incubated in ventrodorsal
position. The site (mid cervical region )was prepared for
aseptically. A 5-6cm long incision was made on skin caudally
to mandibular angle and extending till jugular bifurcation.
Subcutaneous fascia were dissected bluntly using fine artery
forcep to isolated the capsule of affected gland. The cheek
muscle and capsule of mandibular salivary gland were
identified. The gland was grasped with Babcock’s forcep. All
the adjacent blood vessel were ligated using catgut size 1.The
gland was gently pulled out and dissection was carried
cranially along the mandibular duct to further expose the
monostomatic and polystomatic portion of sublingual gland,
the ventral portion of gland was dissected (deroofing)and
hence marsupialization was done suturing the interior layer
of mucocele to the muscle and skin using nonabsorbable
suture material linex size 1.These allows the mucocele to
open and drain outside and enhance adjacent subcutaneous
tissue healing . Postoperatively, the dog was administered
inj.cefotaxime@15mg/kg ,IM B.D for 7 days and
inj.melonex@0.5mg/kg, IM daily for 3 days, antiseptic
dressing of surgical wound and daily flushing of cavity with
normal saline was done followed by gauge packing the cavity
with metronidazole solution. The dog was evaluate for
wound recovery and healing on day 12 and later on various
time intervals. The dog has shown an uneventful recovery
without any post operative complications.
References
1.Bellenger CR, Simpson DJ: Canine sialoceles: 60 clinical
cases, J Small Anim Pract 33:376, 1992.
2.Shiva Raju S, Maiti SK, Kalaiselvan, et al. Surgical
management of cervical mucocele associated with ranula in a
dog. MOJ Anat & Physiol. 2018;5(3):201–203.
DOI: 10.15406/mojap.2018.05.00191.
3.Dunning D. Oral cavity. In: Slatter D, editor. Textbook of
small animal surgery.3rd ed. Saunders, Philadelphia, PA, USA;
2003. pp. 553–572.
4.Hedlund CS, Fossum TW. Surgery of the oral cavity and
oropharynx. In: Fossum TW, editor. Small animal surgery. 3rd
ed. Mosby, St. Louis, Mo, USA: Elsevier; 2007. pp. 339–372.