Management of an extensive equine juvenile ossifying fibroma by rostral mandibulectomy and reconstruction of the mandibular symphysis using String of Pearls plates with cortical and cancellous bone autografts.
Authors: Ogden Nadine K E, Jukic Chantelle C, Zedler Steven T
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Surgical Management of Juvenile Ossifying Fibroma in an Equine Patient Juvenile ossifying fibromas are rapidly progressive mandibular tumours in young horses that pose significant challenges for surgical management, particularly when they involve the mandibular symphysis—the midline fusion point critical to jaw stability and function. This case report documents the surgical technique and outcomes for a 5-month-old warmblood filly with an extensive tumour extending caudally into the symphyseal region, managed through rostral mandibulectomy followed by symphyseal reconstruction using String of Pearls (SOP) plating combined with cortical and cancellous bone autografts. The tumour was successfully excised, and the mandible was reconstructed using cortex screws in lag fashion alongside bone grafts harvested from the contralateral mandible and tuber coxae; notably, the construct remained sufficiently stable to support healing even after implant removal at 9 months due to infection, with the horse developing a new stable symphysis and returning to normal prehension and mastication. This technique demonstrates that complete surgical excision with rigid internal fixation and biological support from autogenous bone grafting is a viable reconstructive approach for mandibular neoplasia, offering both functional and cosmetic outcomes that satisfy owner expectations. The authors' experience suggests that equine practitioners encountering extensive mandibular pathology affecting the symphysis need not accept poor prognosis, provided adequate imaging, surgical planning, and multimodal reconstruction strategies are employed.
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Practical Takeaways
- •Extensive mandibular tumors can be managed surgically with good functional and cosmetic outcomes using String of Pearls plates and bone grafting techniques
- •This reconstruction technique provides sufficient stability to support healing even when implants must be removed due to infection
- •Young horses can achieve normal eating and chewing function after mandibular reconstruction, making surgical excision a viable treatment option for mandibular neoplasia
Key Findings
- •Rostral mandibulectomy with String of Pearls plate reconstruction successfully resolved extensive juvenile ossifying fibroma in a 5-month-old filly
- •Mandibular symphysis reconstruction using cortical and cancellous bone autografts achieved stable healing and formed new stable symphysis by 9 months of age
- •Horse recovered normal prehension and mastication function despite implant removal due to infection