Laryngeal Paralysis Flashcards
What 3 anatomical structures are affected by laryngeal paralysis?
- cricoarytenoideus dorsalis muscle - responsible for abducting the arytenoid cartilage
- recurrent laryngeal nerve - innervates CAD
- cricoarytenoid cartilage - corniculate and cuneiform processes
What is the most common cause of laryngeal paralysis? What are some other possibilities?
idiopathic
- trauma
- cranial mediastinal or cervical mass compressing recurrent laryngeal nerve
- neuropathy / polymyopathy
- hypothyroidism
What signalment is most commonly associated with laryngeal paralysis?
- older dogs ~9 y/o
- Labrador Retrievers
- Golden Retrievers
- St. Bernards
- Irish Setters
What are the 4 most common signs of laryngeal paralysis? What else may be seen?
- inspiratory stridor
- voice change
- dyspnea
- aspiration pneumonia
coughing, gagging while eating, dysphagia, cyanosis, syncope, decreased endurance
How is a definitive diagnosis of laryngeal paralysis achieved? What can aid in this diagnosis?
laryngeal examination under a very light plane of anesthesia to maintain laryngeal function
Doxapram - stimulates respiration to help visualize arytenoid function
What is considered the treatment of choice for laryngeal paralysis? What are 5 other options?
cricoarytenoid lateralization (laryngeal tie-back) - 10-28% develop pneumonia after surgery
- partial laryngectomy - 50% complication rate
- permanent tracheostomy
- reinnervation of laryngeal muscles
- castellate laryngofissue
- video and laser-assisted unilateral partial laryngectomy
What is the most common complications associated with a partial laryngectomy and a castellated laryngofissue to treat laryngeal paralysis?
laryngeal webbing
edema and hemorrhage
When is a permanent tracheostomy preferred in cases of laryngeal paralysis?
in patients with an increased risk of aspiration pneumonia
