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Module 15 > Upper Resp Tract: BOAS Surgery > Flashcards

Upper Resp Tract: BOAS Surgery Flashcards

1
Q

what is stertor

A

snoring noise

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2
Q

what does stertor indicate

A

reverberant airflow in upper airway

excessive or redundant soft tissue

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3
Q

when does stertor get worse

A

when sleeping or excited

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4
Q

what is stertor commonly seen with

A

commonly seen with BOAS

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5
Q

what is brachycephalia

A
  1. shorted nasal cavity
  2. soft tissue obstruction of nasal and pharyngeal cavities
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6
Q

what are the consequences to brachycephalia (3)

A
  1. increased effort to move air
  2. turbulent airflow leads to stertor and inflammation + thickening of soft tissue
  3. mobile soft tissues to collapse into the airway
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7
Q

how does inflammation + thickening of the soft tissues occur in brachycephalic dogs

A

microtrauma with turbulent airflow which causes tissues to hypertrophy and swell

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8
Q

how do soft tissues collapse into the airway in brachycephalic dogs

A

As resistance to airflow increases (as airway gets narrower) then requires more effort which puts more negative pressure on walls of the airway and mobile structures such as the laryngeal lumen, glottis, tonsils, soft palate get pulled and stretched and collapse into the airway and exacerbate the problem

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9
Q

what are the primary disorders of BOAS (5)

A
  1. elongated soft palate
  2. stenotic nares
  3. excess pharyngeal mucosa
  4. narrowed nasal passages
  5. reduced airflow URT
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10
Q

what are the secondary disorders of BOAS (5)

A
  1. soft palate thickening
  2. laryngeal saccule eversion
  3. laryngeal collapse
  4. tonsillar prolapse
  5. inflammmation and swelling of soft tissues
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11
Q

how does BOAS cause regurgitation

A
  1. pressure effects
  2. hiatal hernia
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12
Q

what primary disorders are able to fixed by simple surgery (2)

A
  1. elongated soft palate
  2. stenotic nares
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13
Q

what secondary disorders can be fixed by simple surgery (2)

A
  1. laryngeal saccule eversion
  2. tonsillar prolapse
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14
Q

what surgeries can be considered in BOAS but are more risky

A
  1. laryngeal collapse
  2. hiatal hernia
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15
Q

how does BOAS present

A
  1. stertor (exacerbated by sleeping/excitement/exercise)
  2. exercise intolerance exacerbated by heat
  3. dyspnea
  4. cyanosis
  5. collapse
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16
Q

how can BOAS be managed in chronic cases (4)

A
  1. weight loss
  2. modify lifestyle: stress, exercise, heat
  3. harness not lead
  4. surgery: early invertention
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17
Q

what should you do with an emergency presentation of BOAS (6)

A
  1. cage rest
  2. cool
  3. oxygen therapy
  4. corticosteroids (dexamethasone NaP)
  5. cautious sedation: butorphanol
  6. consider aspiration pneumonia
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18
Q

how do emergency BOAS cases present

A

history of stertor, exercise intolerant, dyspnea

worked up into an increased resp rate and effort and increased turbulence of airflow has caused trauma and swelling of the airway tract which obstructs the airway furhter –> viscous cycle

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19
Q

what surfery is used to correct stenotic nares

A

vertical wedge resection

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20
Q

how do you diagnose an elongated soft palate

A

evaluate under GA

laryngoscope

stylette to depress epiglottis

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21
Q

what is an elongated soft palate

A

glottis opening to the larynx and the soft palate should stop earlier and not extend or obscure the laryngeal opening

it can be sucked into the larynx

22
Q

how is an elongated soft palate corrected surgically

A

caudal poles of the tonsils

or

tip of glottis

23
Q

what are everted laryngeal saccules

A

the laryngeal saccules pop out and obstruct the ventral half of the glottis

24
Q

what is laryngeal collapse

A

arytenoid cartilages collapse medially

obstruction of the dorsal glottis

serious sequelae to BOAS

25
Q

what is the first line treatment to laryngeal collapse (2)

A
  1. correct other BOAS issues: palate, nares, saccules
  2. instigate lifestyle modification
26
Q

what is the second line treatment to laryngeal collapse (2)

A

widening procedures for glottis

  1. arytenoid lateralization
  2. partial arytenoidectomy
27
Q

what are salvage treatments to laryngeal collapse

A

permanent tracheotomy but there is a high mortality rate in dogs

28
Q

how does regurgitation occur in BOAS

A

sliding hiatal hernia

increased intrathoracic pressure due to dyspnea

association with gastritis

saliva and food trapped in pharyngeal folds

29
Q

what is stridor and when does it occur

A

harsh noise on inspiration

resolves at rest/sleeping

exacerbated by exercise/excitement

30
Q

what does stridor indicate

A

failure of glottis to open on inspiration

31
Q

what type of dogs is stridor seen in

A

large breed dogs secondary to laryngeal paralysis

32
Q

what is laryngeal paralysis

A

glottis doesn’t abduct on inspiration

dorsal cricoarytenoids muscle failure

vocal cords slack and reverberate

33
Q

what is the etiology of laryngeal paralysis

A
  1. idiopathic acquired
  2. congenital
  3. secondary
34
Q

what are the secondary causes of laryngeal paralysis (4)

A
  1. polyneuropathy
  2. polymyopathy
  3. neuromuscular junction disorder
  4. iatrogenic injury to recurrent laryngeal nerve (thyroidectomy)
35
Q

when is idiopathic acquired laryngeal paralysis seen

A

older medium to large breed dogs

labs over represented

36
Q

what is idiopathic acquired laryngeal paralysis indicative of

A

progressive

mild

denegerative polyneuropathy

37
Q

what breeds is congenital laryngeal paralysis

A

Bouvier des Flandres

rottweilers

dalmatian

white GSD

38
Q

when is secondary laryngeal paralysis seen

A

uncommon

part of wider neuromuscular disorder

39
Q

what are the signs of secondary laryngeal paralysis

A
  1. swallowing disorders
  2. ataxia
  3. cranial nerve defect
  4. muscle weakness
40
Q

how is laryngeal paralysis diagnosed

A
  1. loss of active abduction on inspiration
  2. assess as recoerving from light plane of anesthesia
  3. avoid premed as suppress normal function
41
Q

how is an emergency laryngeal paralysis managed

A
  1. aspiration pneumonia: systemic antibiotics
  2. dyspnea crisis: sedate, cool, oxygen, temporary tracheostomy or refer for surgery
42
Q

what is the surgery for laryngeal paralysis

A

usually refer for management

crico-arytenoid lateralization (tie-back) surgery –> permanently open one side of glottis, increased risk of aspiration postoperatively

43
Q

what are feline upper respiratory diseases (4)

A
  1. nasopharyngeal polyps
  2. neoplasia: squamous cell carcinoma (tonsil, larynx), lymphoma
  3. BOAS rare
  4. laryngeal paralysis uncommon (iatrogenic, idiopathic)
44
Q

how does acquired laryngeal paralysis present (4)

A
  1. progressive 6m-2 years
  2. inspiratory stridor at exercise
  3. dysphonation
  4. exercise intolerance
45
Q

how does dyspneic crisis present with laryngeal paralysis

A
  1. dyspnea at rest
  2. inspiratory stridor
  3. cyanosis
  4. collapse
  5. death

exacerbated by stress, exercise, heat

common summer presntation

46
Q

how does aspiration pneumonia present with laryngeal paralysis (5)

A
  1. dyspnea at resk
  2. inspiratory stridor
  3. cyanosis
  4. pyrexia
  5. productive cough
47
Q

how does laryngeal paralysis increase the risk of aspiration pneumonia

A

glottis fails to close on swallowing

patient inhales food or fluid

48
Q

what are feline nasopharyngeal polyps

A

originate in the tympanic bulla

aural masses: grow out of ear canal

nasopharyngeal masses grow down esutachian tube

49
Q

what are nasopharyngeal polyps associated with

A

respiratory viruses

50
Q

when are nasopharyngeal polyps seen in cats

A
51
Q

what are the signs of nasopharyngeal polyps in cats

A

swelling above soft palate

stertor

swallowing issues

52
Q

what is the treatment of nasopharyngeal polyps in cats

A

traction and steroids

middle ear surgery to currette base

Module 15 (27 decks)

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