Surgery of upper airways. Medical diseases of oral cavity & oesophagus Flashcards
progressive ethmoid hematoma - PEH
unknown origing
avoid surgery - innervation
progressive ethmoid hematoma - PEH
clinical signs
exercise intolerance
progressive ethmoid hematoma - PEH
treatment
spinal needle to inject formalin
if formalin goes into venous circulation or brain, the horse will die
guttural pouch tympany
predisposing factors
arab, paint horse
filly> colt
uni > bilater
guttural pouch tympany
signs
during swallowing, both GP will open and some air will pass by
but air doesnt come out
air-pillow palp
unilat but looks bilat
guttural pouch tympany
cause
plica salpingopharyngea
guttural pouch tympany
diagnosis
endscope - pharynx collapsed dorsally
xray - radiolucent
guttural pouch tympany
treatment
foley cathter for 203weeks
transendoscopic laser surgery
mm - fold removal
guttural pouch mycosis
symptoms
bloody brownish nasal discharge
excessive nasal bleeding
which artery is affected in guttural pouch mycosis
internal carotid in 70% of cases
use balloon occlusion to treat
surgical treatment for guttural pouch mycosis
cut vessel
push balloon catheter above gp
blow up
mycostic plaque somewhere in between
functional disorders of the pharynx
dorsal displacement of the soft palate
pharyngeal collapse
devellopmental abnormalities of the pharynx
palatochisis
choana atresia
what type of breather is a horse
obligate nasal breather
DDSP treatment - dorsal displacement of the soft palate
conservative
- tongue tie (laryngeal position)
- cornell collar
- training
- pharyngeal muscle weakness (nsaids, figure 8 noseband)
surgical
- laryngeal tie forward
- myectomy
- staphylectomy
- scarring soft palate with laser
rostral pharyngeal collapse
noise during expiration
dorsal/lateral pharyngeal collapse
noise during inspiration
choana atresia
nasal passage ending blindly
unilat can be assymptomatic
bi lat needs laser resection
palatoschisis
milk comes back through nose in new born foal
if the hard palate is involved, euthanisia
pharyngeal cysts location
subepiglottial
in pharyngeal wall
in soft palate - rare
removal of pharyngeal cysts
surgical excision
laser
dynamic disorders of larynx
recurrent laryngeal hemiplegia
axial deviation of aryepiglottic fold
proc. cornuculatus collapse
intermittent epiglottis entrapment
epiglottis retroversion
permanent disorders of larynx
epiglottis entrapment
arytenoid chondritis
subepiglottial cyst
4 BAD
2 processes on arytenoid cartiage
corniculate
muscular
muscles of larynx
m. cricopharyngeus -
m. thyreopharyngeus
m. thyeohyoideus
m. cricoarytenoideus dorsalis
abductor of larynx
opens the larynx
m. cricoarytenoid dorsalis - recurrens
m. cricothyroid —n. laryngeal cranial
adductor of larynx
closes the larynx
m. ay trans
m. cricoarytenoid lat
m. ta
all n. recurrens
RLN
ILH
recurrent laryngeal neuropahty
idiopathic laryngeal hemiplegia
pathogenesis of RLN and ILH
progressive degeneration of dis fibres of the recurrent laryngeal nerve
causes of RLN and ILH
Or due to large size of animal
genetics
strangles
GP mycosis
intoxications
tumours
EMND
RLN and ILH
clinical signs
noise on inspiration
poor performance
definition of RLN and ILH
paresis/paralysis of RLN leading to m. atrophy, vocal cord collapse and arytenoid cartilage collapse during inspiration
diagnosis of RLN and ILH
palpation
us of larynx
endoscope
noise
endscope of larynx
Abduction
Movement of the corniculate process of the arytenoid cartilage away from the midline of the rima glottis
endscope of larynx
Adduction
Movement of the corniculate process of the arytenoid cartilage toward the midline of the rima glottis
endscope of larynx
Full abduction
Most of the corniculate process of the arytenoid cartilage lies horizontally (90 degree to the midline of the rima glottis)
endscope of larynx
Asymmetry
A difference on position of the right and left corniculate processes relative to the midline of the rima glottis
endscope of larynx
Asynchrony
Movement of the corniculate processes occurs at different times. This can include twitching, shivering and delayed or biphasic movement of one arytenoid
grade I RLN
all arytenoid cartilage movemnets are syncs and symmattrical
full abduction can be achieved and maintained
grade II RLN
arytenoid cartilage are async and asymmetrical
full aabduction can be acheived and maintained
grade II RLN
arytenoid cartilage are async and asymmetrical
full abduction cannot be acehived and maintained
must do dynamic as well
grade IV RLN
complete immobility of the arytenoid cartilage and vocal cord
treatment of RLN
laryngoplasty and ventriculocord ectomy
arytenoidectomy
laryngeal pacemaker - not grade 4
compliations of RLN surgery
laryngospasmus
oedema
wound infection
cough
axial deviation of aryepiglottic fold
occurance
- Just DYNAMIC disorder
- Often bilateral, if not, than right sided
- Race horses
axial deviation of aryepiglottic fold
treatement surgical
Transendoscopic laser excision
o Cut of a triangle
o Check the wound healing after 40-60 days
axial deviation of aryepiglottic fold
clinical signs
- Poor performance
- Worse with time
- More frequent in older horses
- ulceration
- kissing lesion
axial deviation of aryepiglottic fold
acute drugs
AB
throat spray
nsaids
tracheotomy
axial deviation of aryepiglottic fold
chronic
partial arytenoidectomy
epiglottic entrapment
clinical signs
- Distinguish epiglottic entrapment and dorsal displacement
- Mucous membrane under the epiglottis is covering the epiglottis ( nothing to do with the soft palate)
- Persistant (97%), seldom dynamic
- Thickened (97%)
- Ulcerated (45%)
- 31-36% together with epiglottic hypoplasia
- Primary inspiratory noise
- Poor performance in race horse
- Can be just an endoscopic finding
- Coughing after drinking water
- Nasal discharge
4 BAD
4th branichial arch defect
congenital
right side collapsed
clincial signs of oral diseases
- Inappetence
- Painful chewing and swallowing
- Swollen face
- Salivation, discharge from the oral cavity
- Halitosis
- Weight loss
- Quidding (dropping food)
- Nasal discharge
- Fistula
- Problems with riding (bit)
- Headshaking
- Bruxism is usually not a sign of oral disease
dysphagia
difficulty swallowing
3 types of dysphagia
prepharyngeal - reluctance to chew
pharyngeal
postpharyngeal
types of dysphagia based on aetiology
o Painful
o Muscular
o Obstructive
o Neurologic
diagnosis of dysphagia
physical exam
endscope
xray
us
management of dysphagia
specific treatment
feeding dry hay not recommended
slurries of pellated feeds
NG tube in severe cases
NaCl or KCl due to salivation
congenital oesophageal diseases
- Oesophageal duplication cysts
- Persistent right aortic arch
- Idiopathic
- Megaoesophagus of foal
acquired oesophageal diseases
- Obstruction (most common)
- Foreign body
- Compression
- Gastrooesophageal reflux disease
- Stricture
- Diverticula (congenital and acquired)
- Trauma, perforation
- Megaoesophagus
- Granulation tissue
- Neoplasia
types of oesophageal obstruction
intraluminal
extraluminal
intramural
functional disorders
predilaction sites of oesophageal obstruction
- Cervical part
- Thoracic inlet
- Base of the heart
- Gastric cardia
clinical signs of oesophageal obstruction
- Signs of dysphagia
- Anxiousness
- Extended neck
- Coughing
- Gagging
- Bilateral, frothy nasal discharge (saliva, water, feed)
- Salivation
- Odynophagia (painful swallowing)
- Distention in the jugular furrow
complications of oesophageal obstruction
- Sign of aspiration pneumonia
- Sign of oesophageal rupture
diagnosis of oesophageal obstruction
- Endoscopy
- Ultrasonography (cervical region, complications)
- Radiography (plain, contrast)
treatment of oesophageal obstruction
sedation
buscopan
acp
oxytocin
NG tube
lavage
flunixin
oesophagitis
ulcerative
reflux
oesophagitis
clinical signs
obstruction, gastric ulceration
oesophagitis
diagnosis
endscope - hyperaemia, oedema, erosions, ulcers
oesophagitis
treatment
