Novel management of a uncommon disease in two young french bulldogs

Frontiers 2022

Mercedes De Paolo, Margherita Gracis, Giuseppe Lacava, Natalia Vapniarsky, Boaz Arzi

Background
Myositis ossificans (MO) involves heterotopic bone formation within muscle tissue and is rarely reported in dogs, especially in the maxillofacial region. This condition, when affecting masticatory muscles, leads to restricted mandibular movement and life-threatening complications. The study aimed to describe the diagnostic and surgical management of MO-like lesions in two young French bulldogs.

Methods

Two cases were evaluated using advanced diagnostic imaging (CT/CBCT) and histopathology. Surgical treatment involved bilateral segmental mandibulectomies using extraoral and intraoral approaches. Elastic orthodontic training devices were used post-operatively to maintain function and facilitate healing. Anesthetic and perioperative care were adjusted due to the severity of the condition and brachycephalic anatomy.

Results
Both dogs presented with progressive inability to open their mouths, minimal mastication muscle changes, and no pain. Imaging revealed dense osseous proliferation in the pterygoid muscle region. Histopathology confirmed heterotopic bone formation. Bilateral segmental mandibulectomy significantly improved function and quality of life. Follow-up indicated static lesions and successful long-term outcomes with minimal complications.

Limitations

The study was based on two cases, limiting generalizability. Although histological and imaging findings supported an MO diagnosis, the lack of progressive heterotopic ossification in one case suggests variability in the disease process. Genetic and traumatic etiologies could not be definitively determined.

Conclusions

This study demonstrates the feasibility of bilateral segmental mandibulectomy as a salvage procedure for MO-like lesions in dogs. The combination of advanced imaging, surgical intervention, and post-operative care enabled acceptable clinical outcomes in these otherwise life-threatening cases. Further research is needed to explore etiology and management optimization.

Figure 1 Cone beam CT images for the dog described in Case 1. (A) CT image demonstrating bilateral smoothly margined, dense osseous proliferation in the location of the lateral pterygoid muscles, spanning the region of the medial pole of the condylar process and tympanic bulla to the medial aspect of the caudal body of the mandible. (B) A 3D reconstruction of the same scan, viewed from the ventral aspect.

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