Upper Airway Dz Flashcards
When dealing with surgery on the nose what is the use of silicon tubes places in the nares:
- Realign the tissue
- - prevents nasal stenosis
Surgical procedure referring to removal of the nose
Nasal planum resection
Most common neoplasia corrected by a nasal planum resection:
_ SCC
Most common neoplasia that is corrected by nasal planum resection
Is the most common nasal planum resection complete or unilateral?
Complete – most common nasal planum resection
– usually the unilateral SCC will be corrected by a complete nasal planum resection because cosmetically & long term will provide better results
What is helpful for planning a nasal planum resection:
CT
– local recurrence due to incomplete excision is one of the most complications, especially dogs.
Type of suture pattern used for nasal planum resection in cats.
Purse string suture works well in cats to decrease size of wound and then the remaining defect is allowed to heal by second intension
T/F: Purse string sutures are used for nasal planum resection to decrease size of wound
FALSE–
Purse string sutures in dogs cause higher risk for nasal stenosis in dogs
What tool can you use to tell if a nasal planum resection is successful
Deep Biopsy to assess margins
T/F: In Nasal Planum resection, purse strings are used in the dog while reconstructive flaps are used in cats.
FALSE
- Dogs: Reconstructive flaps
- -Cats: Purse string sutures
2 common complications of a nasal planum resection:
- Dehiscence – Tension on flaps
- Stenosis – appears to be more common in dogs & techniques that result in good nasal mucosa (skin apposition preferred)
What is the key to preventing stenosis in a nasal planum resection:
–Direct opposition: Oppose the SKIN & NASAL MUCOSA as much as possible around the defect.
When the suture is under too much tension what is a common complications
Dehiscence
Stenosis may require reconstruction with flaps from the _____ _____ to minimize recurrence
Mucocutaneous junction of the lip
Treatment of a Fibrosarcoma
Nasal planectomy & Maxillectomy
What tool is used in a Nasal planectomy & maxillectomy
Oscillating saw
– electrosurgery to achieve hemostasis
What suture pattern is used with a nasal planectomy /maxillectomy in order to achieve skin to nasal mucosa
Modified figure 8 pattern
– wraps around the edge of the skin. This reduces the risk of post op stenosis problems.
Name the openings from the caudal part of the nasopharynx
Choanal – bony structures covered by mucosa with no room for swelling if something were to occur, resulting in choanal atresia/stenosis
What type of infection can get into the nasal cavity causing big white masses that grow into the nasal cavity.
Rhinosporodiosis
– surgical incision is almost impossible to eradicate the disease.
Most common neoplasia of the nasal cavity:
Adenocarcinoma – treated by radiation therapy
other neoplasia of the nasal cavity: Adenocarcinoma, SCC, Lymphoma, mast cell tumors, polyps.
3 most common problems in the nasal cavity:
- Nasopharyngeal stenosis: common in brachycephalics; problem with he choani of the nasal turbinates creating an obstructive lesion. Creates problems moving air in through the nasal passages.
- Trauma
- Neoplasia: Adenocarcinoma, SCC, lymphoma, Mast cell tumors, polyps
Inflammatory masses that normally originate from the top of the Eustachian tube close to the middle ear.
Nasal pharyngeal polyps
In diagnosing nasal disease, what is the FIRST diagnostic with nasal disease.
Imaging –** Computed Tomography**
– Imaging is done first to avoid creating an artifact from bleeding.
In diagnosing nasal disease, what is important about the order of the diagnostics
Imaging FIRST
Rhinoscopy & Naspharyngoscopy SECOND
What instrument must be measured & marked to insure you do not go to the olfactory part of the brain ( if there is tumor erosion of the cribiform plate).
Rhinoscopy & Nasopharyngoscopy
T/F: Bacterial culture is helpful in diagnosing nasal disease
FALSE – normal bacteria in the nose.
- Bacterial culture unlikely to be helpful in diagnosing nasal disease.
- PCR for Bartonella and mycoplasma sp.
If you suspect bartonella or mycoplasma sp causing nasal disease, what would be the best diagnostic tool:
PCR – for bartonella & Mycoplama sp.
If you suspect nasal disease in the sinuses what surgical approach would you use with a rhinotomy.
Dorsal Rhinotomy: access to nasal cavity and SINUSES
If you suspect nasal disease in the choanae, what would be the best surgical approach with a rhinotomy:
Ventral Rhinotomy: access to ventral nasal cavity & choanae
Out of a dorsal & ventral rhinotomy, which is most commonly used:
Dorsal Rhinotomy
Name some of the complications for nasal surgery
Nasal Sx complications:
- Hemorrhage
- flap necrosis
- -oronasal fistula
- -dehiscence
- stenosis of airway
- -incomplete resection/local recurrence (for neoplasia)
When all the contents of the nasal cavity is removed, it is disrupting of the normal clearing mechanism resulting in what long term complication
Chronic nasal discharge
– drainage usually moves cranial to caudal but with removal of the cilia sometimes it doesn’t drain correctly resulting in chronic nasal discharge.
– This commonly occurs with stenosis of airways from partial removal of turbinates.
What is commonly associated with stenosis of the airways after a partial removal of the turbinates
Chronic nasal discharge
***Pope went back to this concept.
T/F: Brachycephalic breeds occur in both cats & dogs
True:
Most common cat breeds associated with brachycephalic syndrome:
- Persians
2. Himalayans
In brachycephalic breeds, why does the nose stop growing?
Early fusion of growth plates
“Local Chrondrodysplasia”
What is the cause of a shortened & broadened skull in brachycephalic breeds:
Local Chrondrodysplasia resulting in early ankyloses of the basioccipital & basisphenoid bones.
What two bones are involved in early ankylosis for brachycephalic breeds:
Basioccipital
Basisphenoid
Name 2 primary components of brachycephalic airway syndrome that can be corrected at birth:
- Elongated soft palate
- Stenotic Nares
- hypoplastic trachea can not be corrected
It is important to correct primary components of brachycephalic syndrome for what reason
Primary components can lead to secondary components effecting the laryngeal & pharyngeal structures (edema, swelling, tonsil enlargement).
Name some secondary/acquired components involved in BAS:
- Everted laryngeal saccules/ stage 1 laryngeal collapse
- pharyngeal/ laryngeal mucosal edema
- tonsillar eversion
- macroglossia
- stage II/III largngeal collapse
- Tracheal collapse
List the steps of pathophysiology of upper airway obstructive disease
- Higher negative pressure to overcome obstruction
- Secondary soft tissue changes (edema, hyperplasia, collapse)
- Decreased air flow with increased obstruction
Most common component of BAS
Elongated soft palate
Term referring to mainly inspiratory dyspnea in BAS:
STERTOR!!!!
Term referring to extension into rima glottides ( Severe obstruction & loss of protective laryngeal function)
Elongated Soft palate
Term referring to dyspnea with airway obstruction at the larynx where the animal has a harder time getting air in. Seen in laryngeal paralysis.
STRIDOR
- stridor = below larynx (trachea)
- -stertor = above larynx
T/F: Endoscopy is a useful tool for elongated soft palate to look in the nasal pharynx.
TRUE
Air passage through nasal cavities accounts for ___% of airway resistance
76.5% of airway resistance
– Abnormal anatomy causes external & internal resistance (Static/ dynamic abnormalities) = inability to dilate the nostrils
