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ACVS Phase II 2023 > Upper Airway > Flashcards

Upper Airway Flashcards

1
Q

Riggs, Vet Surg, 2019:
Exercise testing and laryngeal auscultation
Sensitivity of clinical examination for BOAS diagnosis pre-exercise test vs after a 5-min walk vs after a 3-min trot?
Sensitivity of laryngeal stridor as a predictor of laryngeal collapse before vs after exercise?

A

Riggs, Vet Surg, 2019:
Sensitivity of clinical examination for BOAS diagnosis was 57% pre-exercise test vs 70% after a 5-min walk vs 93% after a 3-min trot
Sensitivity of laryngeal stridor as a predictor of laryngeal collapse was 60% before exercise vs 70% after exercise

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2
Q

Tarricone, Vet Surg, 2019:
Brachycephalic risk (BRisk) score for predicting risk of post-op complications
Association between BRisk and outcome?
Dogs with BRisk scores greater than what value were 9 times more likely to have a negative outcome?

A

Tarricone, Vet Surg, 2019:
BRisk score was associated with negative outcome
Dogs with BRisk scores >3 were 9 times more likely to have a negative outcome

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3
Q

Liu, Vet Surg, 2019:
Laser-assisted turbinectomy (LATE)
What measurement was the only predictor for candidacy for LATE in addition to conventional multilevel BOAS surgery?
What were the most common clinical signs observed after LATE?

A

Liu, Vet Surg, 2019:
CT-based measurement of soft tissue proportion at the rostral entrance of choanae was the only predictor for candidacy for LATE in addition to conventional multilevel BOAS surgery
60% had temporary episodes of reverse sneezing, and 40% had nasal noise when sniffing and excited

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4
Q

Gobbetti, Vet Surg, 2018:
Permanent tracheostomy for severe laryngeal collapse secondary to BOAS
Major complication rate?
Early mortality rate?
What was the leading cause of acute early death?
What % of dogs had obstruction of the stoma caused by skin folds?

A

Gobbetti, Vet Surg, 2018:
80% major complication rate
40% early mortality rate
Stoma obstruction by secretions and mucus plugs was the leading cause of acute early death
20% had obstruction of the stoma caused by skin folds

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5
Q

Gianella, JVIM, 2019:
What % of dogs had GI signs?
What % of dogs had varying degrees of laryngeal collapse?

A

Gianella, JVIM, 2019:
77% had GI signs
87% had varying degrees of laryngeal collapse

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6
Q

Worth, JAVMA, 2018:
Temporary tracheostomy requirement post-op
What factor increased the odds of requiring temporary tracheostomy post-op?
Did the staphylectomy technique (CO2 laser vs incisional) affect the odds of requiring temporary tracheostomy post-op?

A

Worth, JAVMA, 2018:
The odds of requiring temporary tracheostomy post-op increased 1.3 times for each 1 year increase in age
No, staphylectomy technique was not associated with the odds of requiring temporary tracheostomy post-op

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7
Q

Sakai, Vet Surg, 2018:
What facilitated the identification of unilateral laryngeal paralysis?

A

Sakai, Vet Surg, 2018:
CO2 administration facilitated the identification of unilateral laryngeal paralysis

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8
Q

Brown, Vet Surg, 2019:
Laryngeal function with propofol induction vs methohexital induction?
Effect of doxapram?
Disadvantages of methohexital?

A

Brown, Vet Surg, 2019:
Laryngeal function did not differ between propofol vs methohexital induction
Doxapram improved breathing scores
Methohexital provided shorter examination times and 25% of the dogs that received methohexital developed seizure-like activity

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9
Q

Ogden, JSAP, 2019:
Incidence of post-op aspiration pneumonia in dogs that did vs did not receive pre-operative cisapride?

A

Ogden, JSAP, 2019:
Incidence of post-op aspiration pneumonia was 2% amongst dogs that received pre-op cisapride vs 12% amongst dogs that did not receive pre-op cisapride

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10
Q

Suematsu, Vet Surg, 2019:
Continuous extraluminal tracheal prosthesis
Mortality rate?
What % of dogs developed post-op laryngeal paralysis?
What % of dogs had recurrent tracheal collapse?
What % of dogs developed tracheal necrosis?
Pre-op harsh cough resolved in what % of dogs?
Pre-op goose-honking cough resolved in what % of dogs?

A

Suematsu, Vet Surg, 2019:
2% mortality rate
2% developed post-op laryngeal paralysis
4% had recurrent tracheal collapse
0% developed tracheal necrosis
Pre-op harsh cough resolved in 87%
Pre-op goose-honking cough resolved in 96%

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11
Q

Weisse, JAVMA, 2019:
Endoluminal stenting
What % of dogs had improvement in goose-honking or raspy breathing?
What % of dogs had improvement in dyspnea?
Major complication rate?
Most common complications?

A

Weisse, JAVMA, 2019:
89% had improvement in goose-honking or raspy breathing
84% had improvement in dyspnea
47% major complication rate
Most common complications were stent fracture and tissue ingrowth

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12
Q

Violette, JVIM, 2019:
Endoluminal stenting
Most common major complications?

A

Violette, JVIM, 2019:
Most common complications were stent fracture (25%), obstructive tissue ingrowth (19%) and progressive tracheal collapse (12%)

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13
Q

Riggs
Exercise testing and grading BAOS
VetSurg 2019

A

Sensitivity for BOAS
~57% pre
~70% 5 min walk
~93% 3 min trot

Laryngeal stridor with Laryngeal collapse
~60% before
~70% after

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14
Q

Fenner
PO regurgitation after BOAS
VetSurg 2020

A

PO regurg
~hx of regurg
~age inversly (1y = 29% decrease)

Regurgitated while hospitalized
~Preoperatively 11%
~24 hours postoperatively 35%

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15
Q

Franklin
Nebulization with Epi in BOAS
VetSurg 2021

A

Decreased BOAS index
~B/f Sx in 10%
~After Sx 14%

Reduction PO more in BOAS 17%
~Pugs 17%
~Frenchies 5%

Nausea was noted as a side effect in four dogs.

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16
Q

Kaye
BOAS and GI signs
JSAP 2018

A

GI sign prevalence 56%
~Frenchies 93%
~English Bulldogs 58%
~Pugs 16%

Improvement in these clinical signs following corrective surgery *Frenchies

17
Q

Hughes
Complications following Sacculectomy
JSAP 2018

A

PO complications more likely with Sacculectomy

18
Q

Darcy
Aspiration pneumonia in BOAS
JAVMA 2018

A

Increase in age risk factor for nonsurvival

Associated with nonsurvival
~increased age
~male sex
~obtundation
~hypoalbuminemia
~azotemia
~high liver enzyme activities

Relative risk of the disease in the population of interest was 3.77 times that for all other breeds.

Median age at disease onset
~Pugs (83 months)
~French Bulldogs (8 months)
~Bulldogs (6 months)

History of GI signs 66%

Neurologic disease
Pugs>Frenchies & Bulldogs

19
Q

Gruenheid
Anesthesia-related complications in BOAS
JAVMA 2018

A

Perianesthetic complications 49%
~brachycephalic 50%
~nonbrachycephalic 48%

Postanesthetic complications 9%
~brachycephalic 4%
~nonbrachycephalic 4%

Increase Perianesthetic
~BOAS
~Longer anesthesia

Decrease Perianesthetic
~increased BW
~Ortho/Rads vs. Soft tissue

Increased PO
~BOAS
~>ASA score
~Ket/Val
~Invasive vs. non-invasive
20
Q

Worth
Temporary trach placement in BOAS
JAVMA 2018

A

Odds for placement increase by 30% per 1 year

Associated with placement
~PO administration of steroids
~Presence of pneumonia

21
Q

Pfeil
Congenital LarPar in Huskies
JAVMA 2018

A

Clinical onset 6.4m

Sx 32% - all improved

Autosomal recessive neuropathy
Associated with
~Blue eyes
~White facial markings
~Oral mucosal tags
22
Q

Grimes
Revisions in Permanent trach
JAVMA 2019

A

Complications 61%
~aspiration pneumonia 19%
~skin fold occlusion 19%
~stoma stenosis 17%

Revision 35%
~increased with BOAS

MST 1,825d
Decreased with
~Steroids
~Tracheal collapse
~older
23
Q

Dolye
Anesthesia after BOAS corrective Sx
JAVMA 2020

A

Decreased complications in subsequent anesthesia 79%

Intra-anesthesia bradycardia
~increased PO complications 4.56x

Every 15 min of anesthesia increase
~postanesthesia complications by 12%
~intra-anesthetic complications by 11%

24
Q

Costa
PO Regurg in BOAS
JAVMA 2020

A

Regurgitation
~w/o 35%
~w/ 9%

Hx of Regruag associated with PO regurgitation

Protocol
~metoclopramide
~famotidine
~restrict opioids
~recovery in ICU
25
Q

Tarricone
BRISK score for BOAS
VetSurg 2019

A

> 3 are 9.1x more likely to have a negative outcome

Soring
~Breed
~Hx of airway Sx
~Procedure Planned
~BCS
~Level of compromise at admission
~rectal temp at admission
26
Q

Mullins
Epiglottic retroversion
VetSurg 2019

A 
Post-op complications 49%
~Subtotal epiglottectomy 17%
~Partial epiglottectomy 50%
~Incisional epiglottopexy 54%
~Non-Inc epiglottopexy 58%
~other 67%

Epiglottopexy > epiglottectomy

MST not reached

27
Q

Peralta
Congenital Palate defects
JAVMA 2018

A

Success 85%

Oronasal fistula 50%
~hard palate
~more common >8m

Fistula at junction of hard and soft palate
~>8m
~hx of failed repair

Unsuccessful <1kg

28
Q

Lesnikowski et al JVIM 2020

What percentage of dogs had positive bacterial culture before intraluminal stent placement? What percentage had positive bacterail cultures after intraluminla stent placement?

A

82% positive pre-procedure

77% positive post procedure

Not statistically different

29
Q

Lesnikowski et al JVIM 2020

What were the most common bacterial isolates pre-tracheal stent placement?

Most common isolates after stent placement?

A

E.coli and pseudomonas

Did not change relative to stent placement

30
Q

Lesnikowski et al JVIM 2020

Risk factors for pathogenic bacteral cultures around the time of tracheal stent placement?

A

> 8 years old

Traditional type collapse

Cardiac disease

Hepatomegaly in young dogs

31
Q

Violette et al JVIM 2019

What major complications were noted with endoluminal stent placement?

A

stent fracture 25%

obstructive tissue ingrowth 19%

progressive tracheal collapse 12%

32
Q

Violette et al JVIM 2019

What are the risk factors for stent fracture?

A

large maximum tracheal diameters and smaller intrathroacic diameters

33
Q

Violette et al JVIM 2019

Shorter survival time after placement of an endoluminal stent was influenced by what major complication?

A

Shorter survival time with stent fracture.

Survival time not influenced by progressive collapse or tissue ingrowth

34
Q

Suematsu et al Vet Surg 2019

What was the survival to discharge after placement of continous extraluminal tracheal prosthesis? Long term survival? Why are these different from previous reports of extraluminal tracheal prosthesis placement?

A

98% surival to discharge

86% alive at 36 months PO

Blunt dissection was used to preseve many of the small vessels that supply the trachea

35
Q

Grimes et al JAVMA 2019

What major complications were reported after permanent tracheostomies? When did they tend to occur relative to surgery?

A

Aspiration pneumonia 19% - 59d after surgery

Skin fold occlusion 19% 99d after surgery

Stenosis of stoma 17% 147d after surgery

36
Q

Grimes et al JAVMA 2019

What factors are associated with shorter survival times following permanent tracheostomy?

A

Dogs with tracheal collapse

Dogs receiving steroids prior to permanent tracheostomy

Older dogs

37
Q

Mayer et al JAVMA 2019
What was the MST for dogs treated with SRT for nasal tumors?

A

388 days
58% died or were euthanized because of local disease progression

38
Q

Dickerson et al Vet Surgery 2019
What percentage of patients had dehiscence following bilateral labial mucocutaneous rotation flaps after planectomy?

A

50% - all required revision surgery

39
Q

Dickerson et al Vet Surgery 2019
What conditions required revision surgery following bilateral labial mucocutaneous rotation flaps after planectomy?

A

dehiscence
oronasal fistula
narrowed nasal opening
deviation of the nasal orifice

ACVS Phase II 2023 (52 decks)

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