Surgical conditions of the nasopharynx Flashcards by zoe cocker

What is an issue with the pharynx compared to sinuses etc?

entirely muscle

strong reliance on proper innervation for structure

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What is the pharynx anatomically?

mucomembranous tube

conduit between nasal passages and larynx

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What are the functions of the pharynx?

breathing
deglutition
vocalization

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What are the pharyngeal muscles?

genioglossus
gentogyoideus
styloglossus
sternohyoideus
omohyodeus

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HO id dilateion and constriction of the pharynx achieved?

coordinated function fo the nasopharyngeal muscles

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What is the nerve supply to back of through?

10, 5 is involved as well

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What animals get pharyngitits (pharyngeal lymphoid hyperplasi)

young horses

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what is the istory of pharyngitits?

nasal discharge
cough
decreased performance/noise? (throat hurts)–turbulence over bumps

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HOw is pharyngitis dx?

endoscopy

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What are the grades fof pharyngitits?

1-4

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What is the treatment for pharyngitis?

regular vaccination against virus induced upper airway inflam

anti-inflammatories
rest! rest! rest! 4-5d (owner’s dont want)–oft go away
sx only if large

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Why must you rest horses with pharyngitis?

turbulent airflow due to the bumps causes more inflammation to the area

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What is the cause of pharyngeal collapse?

dysfunction of stylopharyngeus muscle (cranial nerve IX)

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Is pharyngeal collapse significant?

yes, but don’t know why? 9-15yr old warmbloods

some degree of collapse normal in exercising horse

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What does the stylopharyngeus msucle do?

hold up the dorsal pharyngeal wall

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Why do you always scope the gutteral pouches with pharyngeal collapse?

because the stylopharyngeus is innervated by cranial nerve IX that runs over gutteral pouch and issues with gutterual pouch can cause neuropraxia of the 9th cranial nerve

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Why shouldn’t you sedate a horse that suspect has pharyngeal collapse?

because sedation causes pharyngeal collapse

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How is pharyngeal collapse diagnosed?

endoscopy (at rest of exercise)

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What is the treatment for pharyngeal collapse?

none

Why should you assess how bad the pharyngeal collapse is before exercising a horse?

because they may get agitated and stop and come off the back of the treadmill

What is the significance of dorsal displacement of the soft palate?

performance limiting

Is dorsal displacemnt of the softt palate common?

yes, often in young raace horses

What are two types of dorsal displacement of soft palate?

static

intermitent/dynamic

What kind of obstruction does dorsal displacement of the soft palate cause?

expiratory airway obstruction

What is the consequence of dorsal displacement of the soft palate?

hypoxia | hypercapnia

What are the theories of etiology of dorsal displacement of soft palate?

1. abnormal soft palate 2. epiglottic hypoplasia 3. excessive caudal retraction 4. caudal retactio nof tongue 5. open mouth 6. neuromscular dysfunction (pharyngeal branch of vagus)

How is dorsal displacement of the soft palate diagnosed?

1. history--they sudden slow down a LOT 2. endoscopy (rest or nasal occlusion or treadmill--more likely to dorsally displace) 3. radiographs (permanent)

Why have two markers on the horse with radiograph?

can account for magnification and measure the length of the epiglottis

Does a short epiglottis lead ot DDSP?

not necessarily

What do you have to be cautious about with DDSP?

find if there are other issues--may be causing the DDSP and DDSP may resolve if resolve that issue (e.g. chondroid causing neuropraxia)

What is medical treatment of DDSP

1. tying tongue? | 2. treat underlying cause?

What are the surgical teatments for DDSP?

1. staphylectomy--resection of caudal aspect of soft palate (soft palate too long?--no evidence!) success 60% 2. myectomy--release caudal traction of larynx. success 60% 3. epiglottic augmentation-teflon injection 4. palatoplasty: stiffen the caudal aspect of the palate. success 60% 5. tie-forward. success 80%

What are complications of staphylectomy to resolve DDSP?

dysphaia, permanent DDSP | and is not better than medical treatment

What are complications of myectomy to resolve DDSP

incisional seroma, infection, cosmetic defect

What is the problem with epiglottic augmentation?

can flop all over the place???

What is the tie forward technique for DDSP?

move the larynx forward and dorsally

What is choanal atresia?

failure to absorbe the bucconasal membrane during embryonic development

is choanal atresia common?

When is choanal atresia a big issue?

when both bucconasal membranes fail to absorb and the foal cannot breathe at birth

What do you do if have unilateral choanal atresia?

laser, punch through,

What is the problem of dealing with unilateral choanal atresia?

have a tendancy to reoccur!

What is a cleft palate?

a congenital defect--opening in palate

Why would you cut a hole in the nasal septum in a case of unilateral choanal atresia?

because membrane has tendancy to reoccur so instead let air go from one side to the other through hole in nasal septum

What are clinical signs of cleft palate?

milk draining from nose and coughing BUT "normal" foals can do this in the first week

how is cleft palate diagnosed?

exam endoscope check for sequelae like aspiration pneumoniae

What is the treatment for cleft palate?

surgical repair or euthanasia - -difficult b/c 1. contaminated 2. has to constantly be moving even under anesthesia--breathing

What is the prognosis for cleft palate?

if greater than 20% soft palate missing, don't try surgery | if only soft palate then prognosis