Mandibular Condylectomy in Dogs

Mandibular condylectomy is a surgical procedure usually performed by a veterinary specialist orthopaedic surgeon. The 'mandible' refers to the jaw bone whilst 'condylectomy' refers to removing the condyle (a knuckle like boney protuberance) that forms the hinge joint which allows the mouth to open and close smoothly. 

Mandibular condylectomy is may be undertaken when the jaw regularly locks open or closed. Removing the condyle allows a new fibrous joint to form which makes for a better range of movement. This surgery is not undertaken lightly, and usually performed only if the dog's existing jaw movement makes eating or drinking consistently difficult.  

Each patient must be carefully assessed to ensure condylectomy is the best and only option. This involves CT scans to intimately check the articulation and anatomy of that individual's temporomandibular joints. For those patients for which the procedure is advisable, then referral to a specialist is indicated.

The patient is given pre-emptive pain relief and general anesthesia induced. Hair is clipped from the side of the face and neck of the affected side. The surgery may be unilateral (one side only) or bilateral (both sides) depending on individual anatomy. 

An incision is made through the skin over the area of the joint, muscles reflected to expose the joint and then a drill with a burr attachment used to remove the condyle. The muscles are repositioned and skin incision sutured.

In the hands of a skilled surgeon, mandibular condylectomy can vastly improve the ability of the dog to open and close the mouth. Over time, as fibrous scar tissue forms, a new joint models itself and the jaw becomes more stable. However, there is a risk associated with surgery of damage to the nerves or blood vessels to the head and neck.

For subluxating jaws, the mandibular condylectomy is being superseded by an alternative procedure where part of the zygomatic arch is removed. This is the bony ridge beneath the eye socket, and it is the interlocking of the ramus of the mandible with this arch that tends to lock the mouth open. Thus, removing the arch is a less complex and arguably more effective option. 

The recovery time from surgery to suture removal is around 10 to 14 days. Patients require soft food for several weeks post surgery, so as not to put a strain on the healing tissue. In addition, the dog should not have chew sticks or toys until healing is complete, since hard chewing could disrupt the formation of the new joint or even cause permanent dislocation. 

The work up necessary for a mandibular condylectomy includes a CT scan at a cost of $800 to $1,500. Consultations with a specialist range in price with $125 to $250 being the norm. The actual cost of surgery depends on the size of the dog and the complexity (such as if old healed fractures are involved) and ranges from $1,000 to $2,500.

Successful surgery can improve the dog's quality of life by enabling greater freedom to eat, yawn, bark, and play ball. However, a significant number of patients may suffer from complications such as decreased range of movement of the jaw due to poor healing or problems lining the jawbone up with the upper arcade of teeth, to chew effectively. 

Once performed, a condylectomy is not reversible, hence the importance of being clear this is the most appropriate procedure for that individual.

Many of the conditions that necessitate a mandibular condylectomy are not subject to external control. For example craniomandibular osteopathy is associated with the Westie breed (hence its common name of 'Westie Jaw'.) This is also true of the flat-faced breeds with distorted anatomy. 

In an ideal world, affected dogs would not be bred from and their parents not used for breeding, so as not to pass down the affected genes. In reality this rarely happens.