Airway surgery Flashcards
What do you need to prepare when intubating a BOAS dog?
Laryngoscope, head lamp
Camera and endoscope
2 blades available for the laryngoscope
cotton buds
What are the components of BOAS?
Naso-pahryngeal hyperplasia macroglossial Stenotic nares Aberrant tubrinates Overlong-thick soft palate Everted laryngeal saccules Tonsillar enlargement Hypoplatisc trachea Broncial collapse
What are the components of BOAS that can be surgically corrected?
Overlong- thick soft plate
Stenotic nares
Everted largyngeal saccules
larynx collapse
What other clinical problems can arise from BOAS and how are they treated?
GI signs will resolve after surgery
Cardia can remain open gastric reflux
CRI Metoclopramide pre-op, post-op omeprazole, zantac, sucralfate
What surgical treatment can be started early in the BOAS dog?
Alar fold resection (Nose)
What additional procedures can also assist with BOAS?
Laryngeal collapse correction
tonsillectomy
What are the three stages of laryngeal collapse?
1 aversion of layrngeal sacculse
2-3 larynx is collapsing
3 completes collapse (can’t medically manage)
What airway condition is common in cats?
naso-pharyngeal and aural polyps
What are the symptoms of Naso-pharyngeal and aural polyp?
URT obstruction
stretor
sneezing
How are Naso-pharyngeal and aural polyps treated?
VBO and steriods
How is Naso-pharyngeal atresia/stenosis treated?
Open surgery and resection of the stenotic area
endoscopic guided resection
endoscopic guided stent placement
What is the etiology of laryngeal paralysis?
Congenital- severe polyneuropathy rapid onset of symptoms less than 12 months of age
Aquired, degenerative disease of the recurrent laryngeal nerve resulting in crico-arythnoidues dorsalis muscle incompetency
How is laryngeal paralysis diagnosed?
Slow onset (excpet congenital) Inspiratory stridor Voice change cough exercise intolerance syncope neurological signs
What is the emergency treatment of laryngeal paralysis?
o2 therapy
anti-inflammatory medication
sedation
tracehal intubation (worst case)
What is the surgical treatment of laryngeal paralysis?
Arytenoid lateralization (tie back) no intra-oral sutures partial laryngectomy not recommended
Why is it important to exam the larynx under a light plane of sedation?
Anaesthetic drugs impact on laryngeal function
What are the post-operative considerations with laryngeal paralysis surgery?
Careful with analgesia protocol Mild sedation 20-30% complication rate life long risk of aspiration megaeophagus neurological condition
What is tracheal colapse?
Dynamic obstruction of the upper airway tracheomalacia common cause of cough in dogs more prevalent in small breeds affects cervical, intrathoracic or both regions
What is the medical treatment for tracheal collapse?
Weight loss management Anti-tussive (butorphanol) Anti-secretory (codeine, hydrocodone, atropine) Bronchodilators (tetrabutaline) Antibiotics
How is the surgical treatment for tracheal collapse preformed?
Stent intra-tracheal
Extra-luminal prosthesis
intra-luminal prosthesis
Self expandable nitinol stents
What are the indications for a permanent Tracheostomy?
Creation of a permanent stoma in the ventral tracheal wall by suturing tracheal mucosa to the skin
Permanent upper airway obstruction
What is the aftercare required for a permanent tracheostomy?
No collar
suction
humidification
What are the complications of a permanent tracheostomy tube?
Mucus and secretions plug stenosis obstruction dehiscence respiratory complication Granulation tissue formation Skin fold obstruction impact on quality of life
