Intro to upper respiratory noise Flashcards
List some reasons for treating URT noise in horses
Dyspnoea
Cosmetics
Poor performance- due to reduced O2 delivery
dysphagia
Describe how to approach diagnosis of URT noise
History
examination of the URT at rest
dynamic examination
static respiratory endoscopy
overground dynamic endoscopy
List 3 conditions which can affect external nares of horse
Epidermal inclusion cysts (atheromas)- cosmetic
Redundant alar folds
Lacerations affecting nostrils
Name a congenital condition that can affect the external nares
wry nose- seen in newborn foals
most euthanised
List the caudal group of paranasal sinuses
Caudal maxillary
Dorsal conchal
Ethmoidal
Frontal
Sphenopalatine
Name the rostral group of paranasal sinuses
Rostral maxillary
Ventral conchal
Which teeth roots can be found in the maxillary sinuses
4th, 5th and 6th cheek teeth roots
which tooth root forms the rostral wall of the rostral maxillary sinus
3rd cheek tooth root
List 3 indications for sinus surgery
Expansive lesions in paranasal sinus
Primary sinusitis
Severe trauma of facial bones
List 3 advantages of a standing sinus surgery
no anaesthetic risks
less haemorrhage
well tolerated by horse
List 3 radiographic findings seen with tooth root infection
tooth more radiolucent
loss of definition of lamina dura
change in periapical region appearance
List the 3 masses of the nasal passages
fungal granuloma
neoplasia
ethmoid haematoma
What must we consider before sinus surgery
which sinus is affected
know anatomical landmarks for each region
consider endoscopic/ laser surgery first as minimally invasive
standing surgery- number of advantages
List 2 conditions which cause noise in the upper respiratory tract of horses
RLN- recurrent laryngeal neuropathy (laryngeal hemiplegia/ roaring)
DDSP- dorsal displaced soft palate
what happens in recurrent laryngeal neuropathy
paralysis of the larynx
gradual deterioration of the nerve fibres in the larynx –> cartilage of the larynx can collapse
what side is paralysis more likely to be on in RLN?
left
List the 3 most commonly used methods of surgical correction used for RLN
Tie back- prosthetic laryngoplasty
Ventriculectomy
Ventriculocordectomy
What is DDSP?
dorsal displacement of soft palate
How does DDSP present? How would you diagnose it?
Obstruction when the horse breaths out because the soft palate acts as a parachute
results in a rise in blood CO2 and exercise intolerance
gurling and growling noises when exercising
endoscopy to diagnose
What is the gold standard surgery for correction of DDSP?
Tie forward
Staphylectomy is not recommended as standard for DDSP, but in which cases might it be appropriate? what is the risk?
for horses with a mass along the caudal free margin of the soft palate
dysphagia is a risk if too much is resected
Describe how to diagnose arytenoid chondritis
endoscopy (resting)
palpation- rounded muscular process
describe how to treat arytenoid chondritis
Medical:
antimicrobials
anti-inflam
+/- Surgical - local excision or arytenoidectomy (if failure of medical management
List 3 reasons to perform surgery on the guttural pouch
tympany- guttural pouch fills with air
Empyema - filled with pus
chondroids
What is the difference between Tracheotomy and Tracheostomy
Tracheotomy (temporary)
Tracheostomy (permanent)
Describe how we treat nala passage masses
transendoscopic removal
How can we identify sinus issues on radiograph
we can look for ‘soft tissue’ or ‘fluid’ opacity in the sinuses
define exodontia
extraction of a tooth
what noise occurs when there is dorsal displacement of the soft palate
expiratory noise
what noise occurs when there is is laryngeal paralysis
inspiratory noise
List 4 possible complications of laryngeal surgery
dysphagia
aspiration pneumonia
excessive abduction
implant failure
How can we diagnose cleft palate
on endoscopy
List 3 clinical signs of cleft palate
nasal reflux of milk/food material
aspirational pneumonia
poor athletic function
what is arytenoid chrondritis
infection or inflammation of the arytenoid cartilages
where is a tracheotomy performed
in the cranial or mid third of the neck - midline - between and parallel to cartilage rings
Describe how to treat guttural pouch empyema
lavage via a foley catheter
Describe how to treat guttural pouch chondroids
basket removal
lavage or surgery
Describe how can we treat a guttural pouch tympany
create a fenestration of the median septum
resect the plica salpingopharangeus or create a salpingopharyngeal fistula
