Test 3: 41 larynx surgery Flashcards
epiglottic cartilage
thyroid
cricoid
arytenoid
what are these
lateral ventricles/ laryngeal saccules
nerves to the larynx
cranial laryngeal nerve- internal and external branch- to cricothyroid muscle
caudal laryngeal nerve- innervates all the other muscles
what are some acquired causes of laryngeal paralysis
- Idiopathic-most common
- Secondary to trauma
- Secondary to various diseases → Polyneuropathy, myopathy, hypothyroidism, neoplasia
- Iatrogenic
- Lead or organophosphate toxicity
- Rabies
lar par is common in what kind of dogs
- Large breed dogs-most common
- Males > females
- Middle-age → older dogs → Labrador, Afghan, Irish setters Golden retrievers, Saint Bernards
- Reported in older cats
- Young (< 1 year)→ – Bouviers, huskies, bull terriers, dalmations, rottweilers
clinical signs of lar par
Inspiratory stridor
Voice change
Exercise intolerance
Dyspnea
Cyanosis
Gagging/Vomiting
restlessness
Exercise, obesity, excitement and heat may exacerbate clinical signs
tests to confirm larpar
CBC/chem- rule out pneumonia as cause
Xray
hypothyroid?
EMG- denervation- not commonly done
histopath
medical treatment of of acute episode of Larpar
Asymptomatic-may not require treatment
- Weight reduction
- Exercise restriction
- Alleviate acute respiratory distress
– Sedation
– Corticosteroids
– Oxygen
– Cooling
May need Emergency tracheostomy if severe
best surgical treatment for lar par
unilateral arytenoid lateralization
explain the unilateral arytenoid lateralization surgery
treatment for larpar
- make incision ventral to jugular groove
- cut cricothyroid articulation
- disect down to cricoarytenoideus dorsalis muscle on the arytenoid cartilage
- cut the cricoarytenoid articulation
- place suture from cricoid cartilage to the muscular process of the arytenoid (pull back)
how to treat everted laryngeal saccule
cut it out- usually caused by brachiocephalic syndrome
can do stenotic nares and soft palate resection at same time
3 stages of laryngeal collapse
laryngeal saccule eversion
aryepiglottic collapse
corniculate collapse
usually 2nd to brachiocephalic syndrome- if severe will need tracheostomy
chronic upper airway obstruction
tracheal collpase is a vicious cycle of —
cough and perpetual inflammation leads to loss of normal tracheal epithelium
miniature breeds
tracheal collapse clinical signs
Clinical signs
– “goose honk”cough
– Dyspnea
– Exercise intolerance
– Cyanosis
– Syncope
– Gagging
More severe in obese animals
Signs can be exacerbated
common in toy breeds
physical exam of pt with tracheal collapse
May present recumbent in respiratory distress
Flaccid tracheal cartilages
Palpation may elicit a cough
Increased inspiratory effort- cervical collapse
Increased expiratory effort- intrathoracic collapse
End expiratory snap-intrathoracic collapse
Important to rule out cardiac disease
toy breeds
grade 1-4 tracheal collapse
how to diagnose tracheal collapse
xray
fluroscopy
tracheoscopy
medical treatment for mild tracheal collapse
Weight reduction
Antibiotics- if pneumonia present
Antitussives- anti cough
Bronchodilators
Corticosteroids
Sedation and oxygen may be required
surgical treatment of tracheal collapse
external rings- go outside trachea and pull trachea open- for cervical and proximal thoracic trachea
intraluminal tracheal stents- for throacic trachea
complications of extraluminal ring placement for tracheal collapse
laryngeal paralysis
tracheal necrosis- rare
complications of tracheal stents for treatment of tracheal collapse
stent fracture
stent migration
granulation tissue formation
