Test 3: 41 larynx surgery

Question 1

Answer 1

epiglottic cartilage

Question 2

Answer 2

thyroid

Question 3

Answer 3

cricoid

Question 4

Answer 4

arytenoid

Question 5

what are these

Answer 5

lateral ventricles/ laryngeal saccules

Question 6

nerves to the larynx

Answer 6

cranial laryngeal nerve- internal and external branch- to cricothyroid muscle

caudal laryngeal nerve- innervates all the other muscles

Question 7

what are some acquired causes of laryngeal paralysis

Answer 7

• Idiopathic-most common
• Secondary to trauma
• Secondary to various diseases → Polyneuropathy, myopathy, hypothyroidism, neoplasia
• Iatrogenic
• Lead or organophosphate toxicity
• Rabies

Question 8

lar par is common in what kind of dogs

Answer 8

• 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

Question 9

clinical signs of lar par

Answer 9

Inspiratory stridor
Voice change
Exercise intolerance
Dyspnea
Cyanosis
Gagging/Vomiting
restlessness
Exercise, obesity, excitement and heat may exacerbate clinical signs

Question 10

tests to confirm larpar

Answer 10

CBC/chem- rule out pneumonia as cause
Xray
hypothyroid?
EMG- denervation- not commonly done
histopath

Question 11

medical treatment of of acute episode of Larpar

Answer 11

Asymptomatic-may not require treatment

• Weight reduction
• Exercise restriction
• Alleviate acute respiratory distress
  – Sedation
  – Corticosteroids
  – Oxygen
  – Cooling

May need Emergency tracheostomy if severe

Question 12

best surgical treatment for lar par

Answer 12

unilateral arytenoid lateralization

Question 13

explain the unilateral arytenoid lateralization surgery

Answer 13

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)

Question 14

how to treat everted laryngeal saccule

Answer 14

cut it out- usually caused by brachiocephalic syndrome

can do stenotic nares and soft palate resection at same time

Question 15

3 stages of laryngeal collapse

Answer 15

laryngeal saccule eversion
aryepiglottic collapse
corniculate collapse

usually 2nd to brachiocephalic syndrome- if severe will need tracheostomy
chronic upper airway obstruction

Question 16

tracheal collpase is a vicious cycle of —

Answer 16

cough and perpetual inflammation leads to loss of normal tracheal epithelium

miniature breeds

Question 17

tracheal collapse clinical signs

Answer 17

Clinical signs
– “goose honk”cough
– Dyspnea
– Exercise intolerance
– Cyanosis
– Syncope
– Gagging
More severe in obese animals
Signs can be exacerbated
common in toy breeds

Question 18

physical exam of pt with tracheal collapse

Answer 18

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

Question 19

grade 1-4 tracheal collapse

Answer 19

Question 20

how to diagnose tracheal collapse

Answer 20

xray
fluroscopy
tracheoscopy

Question 21

medical treatment for mild tracheal collapse

Answer 21

Weight reduction
Antibiotics- if pneumonia present
Antitussives- anti cough
Bronchodilators
Corticosteroids
Sedation and oxygen may be required

Question 22

surgical treatment of tracheal collapse

Answer 22

external rings- go outside trachea and pull trachea open- for cervical and proximal thoracic trachea

intraluminal tracheal stents- for throacic trachea

Question 23

complications of extraluminal ring placement for tracheal collapse

Answer 23

laryngeal paralysis
tracheal necrosis- rare

Question 24

complications of tracheal stents for treatment of tracheal collapse

Answer 24

stent fracture
stent migration
granulation tissue formation

Question 25

temporary vs permanent trachestomy in small animal

Answer 25

temporary- sutures around rings and pull rings apart

permanent- suture muscle to bottom of trachea and remove part of trachea then suture close

Question 26

complications of tracheostomy

Answer 26

Temporary

• Accidental extubation
• Occlusion- secretions
• Risk of pneumonia

Permanent

• Skin fold occlusion
• Occlusion- secretions
• Stomal stenosis
• Risk of pneumonia
• No swimming!

Question 27

most common laryngeal tumors

Answer 27

Lymphosarcoma-most common in the cat

Squamous cell carcinoma

Question 28

most common tracheal tumors

Answer 28

osteosarcoma

Question 29

clinical signs of laryngeal and tracheal tumors

Answer 29

• Middle aged to older animals
• Acute or progressive history of upper airway obstruction
• Stridor, dyspnea, cough, voice change
• Exercise intolerance, hyperthermia
• Gagging, dysphagia, cyanosis, syncope
• Laryngoscopy and bronchoscopy
  – Allows for visualization and biopsy

Question 30

surgical treatment for tracheal and laryngeal tumors

Answer 30

laryngeal- not common to resect

tracheal- resection and stenting may work