SA BOAS Flashcards
what is stertor
low pitch respiratory noise caused by structures above the larynx (nasal structures)
what is stridor
high pitch respiratory noise caused by the larynx itself or structures below
what are clinical signs of BOAS
Stertor
stridor
regurgitation/vomiting
exercise intolerance
coughing due to aspiration pneumonia
sleep apnoea
collapse
cyanosis
how is BOAS diagnosed
signalments and clinical signs
examination of airway
radiography
what are the primary conditions of BOAS (estp)
elongated soft palate
stenotic nares
tracheal hypoplasia
pharyngeal collapse
what are the secondary complications of BOAS (etlt)
everted laryngeal saccules
tonsillar enlargement
laryngeal collapse
tracheal collapse
describe the three grades of laryngeal collapse
grade 1: eversion of laryngeal saccules
grade 2: eversion of laryngeal saccules with medial deviation of cuneiform process of aryntenoids
grade 3: eversion of laryngeal saccules with medial deviation of cuneiform process and deviation of corniculate process of the arytenoid cartilages
why would thoracic radiographs be useful in investigation of BOAS
to rule out aspiration pneumonia and visualise severity of hypoplastic trachea.
Also rule out cardiac disease as cause of tracheal collapse
why do BOAS patients often develop hiatal hernias
due to an increased effort in breathing.
This is the most com mon cause of HH
why is CT not appropriate to diagnose hiatal hernia
as it is a dynamic condition. fluroscopy is more appropriate for this.
describe the four grades of hiatal hernia
1: gastro-oesophageal junction enters abdominal cavity (sliding hernia)
2: stomach fundus region enters abdominal cavity
3: gastro-oesophageal junction and section of stomach fundus enters abdominal cavity
4: organ other than stomach portrudes
describe BOAS surgery
1: laryngeal sacculectomy
2: soft pallate resection (palatoplasty)
3: vertical wedge rhinoplasty of stenotic nares
*gastropexy IF hiatal hernia present
what are post op complications of BOAS surgery
airway swelling and obstruction. Give corticosteroids pre surgery to reduce this
monitor carefully for regurgitation!
post op analgesia
feed soft food only
Omperazole
how would you stabilise an emergency BOAS patient
place in a cool quiet environment
provide supplementary oxygen
IV corticosteroids
sedate or anaesthetise and intubate if needed
