Ch. 100: Palate Flashcards
Sarran JSAP 2018
Position of maximal nasopharyngeal maximal occlusion in relation to hamuli pterygoidei: use of hamuli pterygoidei as landmarks for palatoplasty in BOAS surgical treatment
% complete vs. partial nasopharyngeal occlusion?
location of max occlusion?
Is this landmark palpable?
Complete nasopharyngeal occlusion 63% and partial occlusion seen 37%
Max nasopharyngeal occlusion was always located directly caudal to hamuli pterygoidei (mean 9.4 mm)
Hamuli pterygoidei easily palpable periop in all cases
Gleason Vet Sx 2020
Biomechanical properties of canine staphylectomies closed with barbed or smooth suture
No difference was detected in yield force, force to first tissue rupture, maximum force, and energy required for yield and maximum force between groups
Mode of failure was not different among groups
Holloway JSAP 2022
Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016-2018)
% complications?
% Os felt sx improved QOL?
The overall complication rate was 8.3%, of which 2.7% were considered major (*no complications were related to the staphylectomy)
The questionnaire was completed by 66.7% of owners - 88% felt that surgery had improved the quality of life for their dog
Carabalona JAVMA 2022
Complications, prognostic factors, and long-term outcomes for dogs with brachycephalic obstructive airway syndrome that underwent H-pharyngoplasty and ala-vestibuloplasty: 423 cases (2011-2017)
% mortality?
% complications?
Px factors?
Risk of death?
Overall mortality 2.6%
Overall complications 12.1%
Px factors: Snoring more likely to be improved if higher grades preop, but less likely to improve in pugs than in French bulldogs. Exercise tolerance was less likely to improve in Pugs and English bulldogs than in french bulldogs.
Risk of death increased by 29.8% for every 1-year increase in age
Mayhew VSURG 2023
ACVS funded ***
Effect of conventional multilevel brachycephalic obstructive airway syndrome surgery on clinical and videofluoroscopic evidence of hiatal herniation and gastroesophageal reflux in dogs
Does surgery improve GERD or hiatal hernia? Results vs. O opinion?
No improvement was detected in masked assessment of preoperative and postoperative VFSS studies in terms of GER frequency or severity, SHH frequency or severity scores.
Conclusion: Owners of dogs treated with CMS perceived an improvement in clinical signs of SHH and GER that was not confirmed by VFSS studies
Conventional multilevel surgery in dogs with BOAS does not appear to consistently resolve SHH and GER, although clinical signs may improve
Peralta JAVMA 2018
Outcomes of surgical repair of congenital palatal defects in dogs
% success?
Most common complication and location?
Functional success in 85% dogs (22/26). Unsuccessful functional outcome more common dogs < 1 kg at time of initial repair.
An oronasal fistula formed after repair in 50% (13) dogs, most common location hard palate
Seriot JSAP 2019
Extended palatoplasty as surgical treatment for nasopharyngeal stenosis in six cats
complications?
long term outcome?
Excision of caudal soft palate & entire stenotic ST membrane successful all 6 cats
No pre, intra, or postop complications
Long-term outcome = no recurrence of CS in 4 cats , 1 cat occasional sneezing , 1 cat died 1 mo postop unrelated
Nakahara Vet Sx 2020
Hard palate defect repair by using haired angularis oris axial pattern flaps in dogs
how far rostral can flap be used?
complications?
Reconstruction of defects extending as far rostral as the maxillary canine tooth were feasible on the cadaver
Minor dehiscence, swelling causing upper airway obstruction (resolved)
Tarricone VSURG 2019
Development & validation of a brachycephalic risk (Brisk) score to predict the risk of complications in dogs presenting for surgical treatment of BOAS
PQ Scores >3 had what outcome?
PQ Was a higher temperature protective or negative?
The 10 point score was modeled on breed, history of previous surgery, concurrent procedures, BCS, airway status, and admission rectal temperature
The score was associated with negative outcome & discriminated well in both the construction (area under the receiver operator characteristic & validation groups
- Dogs with scores > 3 were 9.1 x more likely to have a negative outcome compared with dogs with scores < 3 *
- “The finding that increased rectal temperature at admission is protective compared with decreased rectal temperature was unexpected.” * (however confusing because inc temp is part of BRISK .. so not sure)
