STS Journals - Respiratory and Thorax Flashcards
Franklin VS 2024 - Comparison of the effectiveness of three different rhinoplasty techniques to correct stenotic nostrils using silicone models: A case study
What rhinoplasty techniques were compared?
Which technique had the greatest increase in cross sectional area? What was the %?
Vertical wedge achieved up to alar fold, modified horizontal wedge up to halfway between nares and alar fold, alavestibuloplasty up to caudal nasal vestibule
Alavestibuloplasty - 74%
Pavlectic JAVMA 2023 - Successful correction of stenotic nares using combined Alar Fold Lift-Up and Sulcus Pull-Down Techniques in brachycephalic cats: 8 cases (2017–2022)
Describe these techniques
What was the outcome of this technique?
See pic
Effective in improving nasal breathing in all affected cats
Andrews JAVMA 2023 - Dorsal rhinotomy in a dog with a chondro-osseous respiratory epithelial adenomatoid hamartoma: a case report
How did this disease appear on CT?
Cyst-like nasal masses with severely destructive bilateral rhinitis with extensive polyostotic bony lysis
Clarke VS 2021 - Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs
How did corrective upper airway surgery affect the nasopharyngeal collapse?
Surgery (alaplasty, staphylectomy, sacculectomy, tonsillectomy) did not improve the reduction in dorsoventral diameter of the nasopharynx during respiration.
(p=0.0505)
Dickerson VS 2020 - Dorsal offset rhinoplasty for treatment of stenotic nares in 34 brachycephalic dogs
Describe the technique
What was the major complication rate?
See pic
0% although 1 dog did have collapse of both nares within 4 years
Berns JFMS 2020 - Single pedicle advancement flap for treatment of feline stenotic nares: technique and results in five cases
Describe the technique
What was the outcome?
See pic
All cats had resolution of stertor and no episodes of resp distress (no complications)
Ferrera-Jorder JFMS 2023 - Description of outcome and adverse events in 21 cats with locally advanced nasal planum squamous cell carcinoma treated with electrochemotherapy
What is the MST for surgery (as per Tobias)?
Describe the nature of this tumour
What was the MST achieved by ECT?
What was correlated with survival?
12 months
Locally invasive (mets to local lymph nodes)
453 days (15 months)
Voltage was correlated with surgery
Ciepluch VS 2023 - Sternohyoideus-sternothyroideus muscle flap to reconstruct oronasal fistulas due to maxillary cancer in four dogs
Describe the technique
How far could this flap extend?
What was the rate of complications?
Flaps were harvested by transecting the ipsilateral sternothyroideus and sternohyoideus muscles from their origin at the manubrium and costal cartilage. The muscles were rotated around the base of the cranial thyroid artery and tunneled subcutaneously in the neck and through an incision in the caudodorsal aspect of the oral cavity. The muscle flap was sutured to the edges of the oronasal fistula.
As far rostral as the level of the 1st premolar without tension
100% - all dogs had partial dehiscence of the flap but all signs improved post-op
Gleason VS 2021 - Biomechanical properties of canine staphylectomies closed with barbed or smooth suture
What was the biomechanical difference between staphylectomies closed with barbed or smooth suture?
No difference in biomechanical properties between 2-0 Quill Monoderm barbed suture and 3-0 monocryl.
Doyle VCOT 2019 - Evaluation of the superior labial musculomucosal flap in dogs: An angiographic study and case report
Where is the superior labial artery?
How is the superior labial MM flap been used in this case report?
A
To reconstruct a large cleft palate
Holloway JSAP 2022 - Split staphylectomy to address soft palate thickness in brachycephalic dogs: 75 cases (2016-2018)
Describe this technique
What was the complication rate?
Midline incision in soft palate, palate muscle excised, excess tissue either side of midline excised & simple continuous closure of oral & nasopharyngeal mucosa completes reverse-U incision.
8%
Sun JSAP 2022 - Evaluation of temporary palatopexy to manage brachycephalic obstructive airway syndrome in dogs in respiratory distress
Describe the technique
see pic
Seriot JSAP 2019 - Extended palatoplasty as surgical treatment for nasopharyngeal stenosis in six cats
Describe the technique
Caudal soft palate rostral to stenosis & stenotic region excised after initial reverse-U incision rostral to tonsils.
Pavletic JAVMA 2023 - Surgical closure of cleft palate defects in dogs using a modification of the traditional von Langenbeck technique: 12 cases (2015–2022)
What was the modification?
What was the outcome?
The use of a layer of vertical mattress sutures to evert flap margins allowing for direct contact of collagen surface and then a layer of simple interrupted
Very minor rostral dehiscence with no clinical consequence
Peralta JAVMA 2018 - Outcomes of surgical repair of congenital palatal defects in dogs
Name the 3 most frequently used palatal defect repair techniques
What % had functional success?
What was the most common complication? How common was it? What was associated with the development of this complication?
What dogs were more likely to have an unsuccessful repair?
Overlapping flap, Von Langenbeck technique, bipedicle flap
85%
Oronasal fistula formation in 50% - more common in dogs >8m of age at initial repair (usually try to do around 3-4m)
Dogs <1kg at initial surgery
Jones VS 2024 - Comparison of mortality of brachycephalic dogs undergoing partial staphylectomy using conventional incisional, carbon dioxide laser, or bipolar vessel sealing device
Which technique was associated with a higher mortality?
What other factors were associated with mortality?
BVSD
Concurrent stage 2/3 LCollapse
Miller VS 2024 - Complications and outcome following staphylectomy and folded flap palatoplasty in dogs with brachycephalic obstructive airway syndrome
What was the differences in outcome and complications observed between the techniques?
Although FFP took longer, no other clinically significant differences were appreciated between S and FFP procedures.
Williams VS 2024 - Evaluation of the addition of adrenaline in a bilateral maxillary nerve block to reduce hemorrhage in dogs undergoing sharp staphylectomy for brachycephalic obstructive airway syndrome. A prospective, randomized study
What was observed?
What adverse effects of adrenaline were noted?
Significantly lower haemorrhage with adrenaline in bilateral maxillary nerve block than lidocaine alone.
No adverse effects of adrenaline noted.
Fracka VS 2024 - Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018–2022)
What risk factors were identified?
Increasing age, long GA, staphylectomy, laryngeal collapse 3
Camarasa JSAP 2023 - Owner-assisted recovery and early discharge after surgical treatment in dogs with brachycephalic obstructive airway syndrome
How did the post-op complications differ between standard recovery and recovery with owners?
Post-op complications higher in standard recovery (28%) than recovery with owners (2%)
Filipas JSAP 2024 - A retrospective observational cohort study on the postoperative respiratory complications and their risk factors in brachycephalic dogs undergoing BOAS surgery: 199 cases (2019- 2021)
What risk factors for tracheostomy were identified?
Risk factors for tracheostomy were preop/postop a.pneumonia and increasing BOAS grade
Castejon-Gonzalez JAVMA 2023 - Use of a barrier membrane to repair congenital hard palate defects and to close oronasal fistulae remaining after cleft palate repair: seven dogs (2019–2022)
What was the barrier membrane used?
How was the cleft palate closed?
What was the outcome?
Autologous auricular cartilage or fascia lata
VL technique or 2 pedicle flaps
Complete success
Gilman JSAP 2023 - A comparison of harmonic and traditional sharp staphylectomy techniques in 15 brachycephalic dogs
What was the difference between the two techniques?
Harmonic associated with less haemorrhage and shorter average surgical time.
No difference in total surgical time, nights in hospital or BOAS grade. No clear difference in tissues on histopathology.
Thermal necrosis compares favourably to previous reports
Drudi VS 2022 - Comparison of immediate and short-term outcomes of cricoarytenoid and thyroarytenoid lateralization in dogs with idiopathic laryngeal paralysis
How did the two techniques compare with respect to the rima glottidis enlargement?
CA - increase in rima glottidis by 200%
TA: increase by 150% (reduced to 125% by d15 PO)
McNamara VS 2022 - Description and evaluation of a novel transoral endoscopic arytenopexy in canine cadavers
Describe the technique
What was the outcome?
Suture placed in the tip of the epliglottis to facilitate exposure. Muscosa on the lateral aspect of the left arytenoid was sutured to the adjacent pharyngeal wall. No cartilage was included. Used barbed suture
Increased rima glottis area but maintained epliglottic coverage
Sakai VS 2021 - Influence of doxapram and intermittent 10% carbon dioxide inspiration on cardiovascular and laryngeal functions in anaesthetised dogs
Why is doxapram used?
What are the SE of Doxapram?
What was the outcome?
To increase the arytenoid movement to aid in diagnosing LarPar.
Hypertension and tachycardia (increases myocardial O2 demand)
All tx (CO2 and Doxapram) increased glottic gap area. CO2 is potentially a safer technique to improve airway exam (c.f. Doxapram)
DeGroot VS 2020 - Examination of laryngeal function of healthy dogs by using sedation protocols with dexmedetomidine
What sedation protocol resulted in a false positive diagnoses of LarPar?
What sedation protocols are recommended by the authors?
For which sedation protocol did Doxapram have the greatest effect?
Propofol ONLY
Dexmed alone or in combo with butorphanol or hydromorphone
Dexmed. No difference in laryngeal motion after administration of doxapram, except when only dexmed used.
The use of doxapram hydrochloride is recommended during laryngeal function examinations when results are in question because its use resulted in wider abduction of the arytenoid cartilages for all four protocols, facilitating the detection of arytenoid abduction.
Mullins VS 2019 - Intraoperative and major postoperative complications and survival of dogs undergoing surgical management of epiglottic retroversion: 50 dogs (2003-2017)
Which three procedures are compared?
Which has the highest failure rate and complication rates?
What was the rate of major complications and the m.common major complication?
Epiglottopexy, partial epiglottectomy and subtotal epiglottectomy
Epiglottopexy
49% - epiglottopexy failure
Dixon JSAP 2022 - Infiltrative laryngeal disease in dogs
What was the most common aetiology?
What was the prognosis for the dogs that survived to discharge?
Inflammatory disease (c.f. Neoplastic)
For dogs that survived to discharge, outcome was fair although relapse was common.
Ogden JSAP 2019 - Effects of preoperative cisapride on postoperative aspiration pneumonia in dogs with laryngeal paralysis
How did the rate of a.pneumonia differ between the tx groups?
How was the cisapride administered?
1/50 cisapride group (2%)
6/52 no cisapride (12%)
As a preop cisapride CRI
Moser JFMS 2022 - Partial laryngectomy for the management of laryngeal masses in six cats
Describe the approach to the partial laryngectomy
How was the defect closed?
What was the most common post-op complication?
What was the most common histo diagnosis?
Ventral midline approach, incision through thyroid cartilage, stay sutures placed and used to retract thyroid cartilage.
Use of a sternohyoideus muscle flap
Resp distress (no other post-op complications)
Lymphoma
Boanno JFMS 2023 - Evaluation of two unilateral laryngoplasty techniques and their effect on arytenoid cartilage abduction in cats
What were the two techniques?
How did they compare?
Single tensioned suture w. or w.out disarticulation of CA
No difference between groups. Both groups resulted in abduction of L arytenoid
Shubert JAVMA 2023 - Outcome following elective unilateral arytenoid lateralization performed in an outpatient manner is comparable to hospitalization for dogs with laryngeal paralysis
What was the overall (inpatient and outpatient) complication rates?
What was the overall mortality (inpatient and outpatient) complication rates?
What was the main conclusion?
23% (35%, 13%)
7% (5%, 4%)
No sig difference between overall rate of complications and mortality rates between the inpatient and outpatient groups
Kanemoto JFMS 2023 - Retrospective study of feline tracheal mass lesions
What were the most common clinical signs?
What part of the trachea was most commonly affected?
What were the most common ddx?
Dyspnoea/distress, wheezing/coughing/gagging, voice changes
Cervical
Lymphoma (MST 214d), Adenocarcinoma, SCC
Janssen VS 2024 - Long-term outcome of permanent tracheostomy management in two brachycephalic dogs using a commercial and a three-dimensional-printed silicone stent
What was the reason behind placement of the stent?
What complication was associated with use of the commercial stent?
Concern regarding stenosis
Skin ulceration
Brismi VS 2022 - Influence of age on resistance to distraction after tracheal anastomoses in dogs: An ex vivo study
How did the TA differ with juvenile dogs?
TAnastomoses failed at lower forces but sustained more elongation in immature dogs - authors suggest use of tension relieving sutures/techniques
De Lorenzi JAVMA 2024 - Dumon silicone stents can improve respiratory function in dogs with grade IV tracheal collapse: 12 cases (2019–2023)
What was the MST?
Complication rate? What were some of the complications seen?
810d
25% died spontaneously
Complications in 75% of cases - included granulation tissue, cough, stent migration and stent deformation
Gibson VS 2024 - Evaluation of mediastinoscopy for cranial mediastinal and tracheobronchial lymphadenectomy in canine cadavers
Describe the port location
What pressure insufflation was utilised?
Which were the easiest L.Nodes to access with this approach?
What post-surgical complication was observed?
The manubrium was palpated and the space ventral to the trachea and dorsal to the sternum identified. A linear longitudinal incision on midline (3–5 cm) was made within this space, and the skin, subcutaneous tissues, and cervical musculature divided to the level of the thoracic inlet with sharp dissection.
2-4mmHg insufflation
Left tracheobronchial LN (7/7), then R (4/7), then sternal LNs (3/7), then cranial mediastinal (1/7)
Post-procedure pleural gas in 4/7 on CT
Shriwise VS 2021 - Lymphaticovenous anastomosis of the caudal thoracic duct to an intercostal vein: A canine cadaver study
What instrument was utilised to facilitate the anastomosis?
In what % of dogs was this successful?
In which vein did the lymphatics drain into?
Microvascular anastomotic coupler
8/8 (100%)
Azygous vein
