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VET433: Cardio/Respiratory > Laryngeal & Nasopharyngeal Disease > Flashcards

Laryngeal & Nasopharyngeal Disease Flashcards

1
Q

signs of laryngeal disease

A

stridor
voice change
panting
exercise intolerance
heat intolerance
hyperthermia
+/- swallowing impairment

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2
Q

signs of nasopharyngeal disease

A

stertor
reverse sneezing

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3
Q

types of laryngeal disease

A

structural:
- neoplasia
- mass
- foreign body

functional:
- laryngeal paralysis

both: laryngeal collapse

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4
Q

types of nasopharyngeal disease

A

nasopharyngeal polyps
nasopharyngitis
nasopharyngeal stenosis

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5
Q

signalment of laryngeal paralysis

A

older large breeds
LABRADOR RETREIVERS

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6
Q

causes of laryngeal paralysis

A

GOLPP
trauma to recurrent laryngeal nerve
mediastinal mass

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7
Q

GOLPP

A

geriatric onset laryngeal paralysis and polyneuropathy

age related degeneration of major nerves
- recurrent laryngeal
- sciatic
- vagus

leads to concurrent laryngeal paralysis, swallowing impairment, and hind limb weakness

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8
Q

diagnosis of laryngeal paralysis

A
  1. PE
  2. cervical & thoracic radiographs
  3. laryngeal exam
  4. +/- swallow fluoroscopy
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9
Q

how to do a laryngeal exam

A

propofol + doxapram
- propofol for sedation
- doxapram to stimulate CNS to properly assess laryngeal function

look for laryngeal paralysis and paradoxical movement

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10
Q

when should arytenoids be open and closed

A

open - inspiration
closed - expiration

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11
Q

paradoxical movement

A

arytenoids close during inhalation and open during expiration

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12
Q

in hospital management of laryngeal paralysis

A

O2 supplementation
sedation - butorphanol
anti-inflammatory steroids

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13
Q

at home management of laryngeal paralysis

A

lifestyle modification
- weight loss
- avoid hyperthermia
- avoid strenuous exercise
- paced, elevated feeding and water

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14
Q

surgical management of laryngeal paralysis

A

unilateral arytenoid lateralization
“laryngeal tie back”

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15
Q

most common complication of laryngeal tie back

A

aspiration pneumonia

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16
Q

norwich upper airway obstructive syndrome

A

congenital laryngeal disease of norwich terriers
- redundant supraarytenoid folds
- laryngeal narrowing and collapse
- everted laryngeal saccules

causes respiratory noise and effort

dx on laryngeal exam
tx with surgery if clinically severe

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17
Q

signalment for nasopharyngeal polyps

A

young cats

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18
Q

etiology of nasopharyngeal polyps

A

polyp of benign inflammatory fibrous tissue that grows from the epithelial lining of the dorsolateral compartment of the bullae

extends aurally to the middle ear OR up the auditory tube into the nasopharynx

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19
Q

clinical signs of nasopharyngeal polyps

A

stertor
reverse sneezing
sneezing
nasal discharge

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20
Q

diagnosis of nasopharyngeal polyps

A
  1. PE
  2. skull & thoracic radiographs (check for bullae involvement)
  3. soft palate rostral traction
  4. CT/nasopharyngoscopy
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21
Q

treatment of nasopharyngal polyps

A

traction avulsion procedure

use rostral traction on the soft palate to expose the polyp in the nasopharynx

grasp the polyp from the stalk and slowly pull using traction and avulsion

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22
Q

signalment of nasopharyngitis

A

cats
high stress and shelter environments

23
Q

what causes nasopharyngitis

A

herpesvirus
calicivirus

24
Q

clinical signs of nasopharyngitis

A

painful, hard swallowing
history of URI
ocular signs (herpes)
oral and lingual ulcers (calici)

25
Q

diagnosis of nasopharyngitis

A

PCR of oral swab for viral etiology

26
Q

what causes nasopharyngeal stenosis

A

acquired due to inflammation

dogs - often from aspiration under anesthesia

27
Q

clinical signs of nasopharyngeal stenosis

A

constant stertor
lack of airflow
+/- nasal discharge

28
Q

pathology of nasopharyngeal stenosis in dogs and cats

A

cats - thin band of fibrous tissue
dogs - thick band of fibrous tissue

29
Q

diagnosis of nasopharyngeal stenosis

A

CT
caudal rhinoscopy

30
Q

treatment of nasopharyngeal stenosis

A

cats: balloon dilation
dogs: balloon dilation + temporary or permanent stent

31
Q

anatomy of feline bullae

A

2 compartments
- ventromedial
- dorsolateral

32
Q

where to nasopharyngeal polyps arise from

A

dorsolateral compartment of the bullae

33
Q

what medication should be provided post-op traction avulsion procedure

A

NSAIDs or steroids x10-14 days PRN

34
Q

what are complications of nasopharyngeal polyp surgery

A

minor bleeding
10-50% recurrence rate
- may require VBO if recurrent
transient Horner’s syndrome

35
Q

otic canal polyps

A

middle ear polyp extends up the ear canal instead of through the auditory tube

36
Q

clinical signs of otic polyps

A

head shaking, pawing at ear, head tilt, otic discharge

37
Q

ventral bulla osteotomy

A

debridement of the polyp attachment to the wall of the bulla in the dorsolateral compartment

38
Q

indications for ventral bulla osteotomy

A
  1. recurrent nasopharyngeal polyps after traction-avulsion
  2. bony changes associated with the bulla
  3. polyp limited to the middle ear with intact tympanic membrane
  4. otic polyp extending into ear canal and owner cannot manage
39
Q

what is the most common complication of VBO

A

seroma

40
Q

do otic or nasopharyngeal polyps have a higher recurrence rate

A

otic
UNLESS VBO procedure is performed

41
Q

unilateral arytenoid lateralization

A

performed on the left arytenoid

suture the arytenoid laterally to the cricoid cartilage to widen the laryngeal opening

42
Q

approach for laryngeal tie back

A

lateral approach into the cartilage

pull cuneiform process of the left arytenoid laterally and suture to the adjacent cricoid cartilage

43
Q

postop care for arytenoid lateralization

A

NPO
IV fluids
analgesia
respiratory monitoring

44
Q

does laryngeal tie back cure the upper respiratory obstruction

A

NO - only improved
increased risk of aspiration pneumonia

45
Q

complications with laryngeal tie back

A

seroma
change in bark
dry cough
recurrent bronchitis
aspiration pneumonia
esophageal or pharyngeal dysfunction
failure of lateralization

46
Q

progression timeline of GOLPP

A

most dogs with idiopathic laryngeal paralysis are likely to develop generalized polyneuropathy within 1 year

47
Q

what causes laryngeal collapse

A

primary cartilage problem
vs
secondary to other respiratory disease that causes increased respiratory effort

48
Q

signalment for laryngeal collapse

A

small breeds
brachycephalics

49
Q

medical vs surgical management of laryngeal collapse

A

medical: lifestyle modification; can avoid surgery as long as patient compensates

surgical: permanent tracheostomy (SALVAGE PROCEDURE)
- end stage disease only

50
Q

epiglottic retroversion signalment

A

middle aged to older
overweight
small breed dogs

51
Q

how does epiglottic retroversion occur

A

secondary to chronic increased inspiratory airway pressures

pulls epiglottis backwards/caudally leading to intermittent obstruction

52
Q

clinical signs of epiglottic retroversion

A

stridor
dyspnea
normal signs of upper airway obstruction

53
Q

treatment of epiglottic retroversion

A

permanent vs temporary tracheostomy

permanent
1. primary epiglottic retroversion
2. concurrent disorders that are chronic or ongoing

temporary
1. secondary epiglottic retroversion when concurrent disorder can be treated

VET433: Cardio/Respiratory (17 decks)

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