URT surgery Flashcards
List the primary pathophysiology’s of BOAS (4)
Stenosis external nares
Overlength of soft palate
Tracheal hyperplasia
Sliding hiatal hernia
List the secondary pathophysiologies of BOAS (8)
Hypertrophy of soft palate
Tonsilar hypertrophy
Everted laryngeal ventricles/ saccules
Laryngeal collapse
Pharyngeal collapse
Glosso-epiglottic mucosa displacement
Scrolling of epiglottic cartilage
Vomiting/ regurgitation
Describe tracheal hypoplasia
where the trachea is narrower in diamater than normal, causing increased resistance to airflow when the animal breaths
Note= On radiographs compare trachea to size of vertebrae
List the 2 surgical methods that can be used to correct stenotic nares
- Rhinoplasty wedge resection- this doesn’t take away the internal alar fold
- Alar fold resection (Leipzig)- this does both internal and external structures
List the 2 ways we can correct soft palates
- Partial staphylectomy= Cut away excess tissue and sew nasal an oral mucosa together
2.Palatoplasty= u shaped incision fold made and pulled forward to thin out
Explain how Idiopathic acquired laryngeal paralysis occurs
Neurogenic atrophy of intrinsic laryngeal muscles
Dysfunction of recurrent laryngeal nerves
Generalised peripheral neuropathy
Central nervous system
Describe the normal Arytenoid movement in normal animal
Inspiration – cartilages are abducted- the harder you need to breathe the wider they abduct
Expiration – cartilages are adducted (air break)
Expiration at exercise – cartilages are abducted
List the 6 clinical signs of acquired laryngeal paralysis
Stridor
Cough
Dyspnoea
Change in phonation (bark)
Exercise intolerance
Collapse
When are the clinical signs of acquired laryngeal paralysis worse
when the dog is hot, excited or exercised
What type of dog most commonly get acquired laryngeal paralysis
older age, larger breed dogs (e.g. 12yr old lab retriever)
but can occur in any breed
How do you diagnose laryngeal paralysis
Characterises clinical signs
Auscultation of larynx/thorax
Laryngoscopy- under a light plane of general anaesthetic
Straight bladed laryngoscope (miller)
What concurrent disease can present with acquired laryngeal paralysis
Cardiac
LRT
Dysphagia
Megoesophagus
Hypothyroidism
What is our emergency management of ACUIRED LARYGENAL paralysis
Rest
Supplement oxygen
Cooling
Sedation
IV access
IV corticosteriods
Tracheostomy tube placement
What is the surgical management of laryngeal paralysis
Arytenoid lateralisation (tieback surgery)
Widen rima glottis and prevent dynamic collapse of arytenoid cartilage
List 5 complications that can occur after a tie back surgery
Seroma formation
Aspiration pneumonia
Inadequate lateralisation
Suture failure
Change in bark
List 5 things that need to occur during the post-op period after a tie-back surgery
Observe feeding and drinking
Strict rest for 2-3 weeks
Antibiotics
Analgesics
Harness
What is tracheal collapse
Condition of excessive collapsibility of the trachea resulting in dorsoventral flattening of the tracheal lumen
THINK TOY BREEDS/YORKIES
List 3 clinical signs of tracheal collapse
Goose honk cough
Pulling on collar/lead
Exercise
List 6 things we can use to medically manage tracheal collapse
Antitussive- anti-cough
Bronchodilators
Antibiotics
NSAIDs
Cortecosterioids (Inhaled)- if severely affected
Bronchodilators (inhaled)
List 2 ways which tracheal collapse can be surgically managed
open ring prosthesis - putting rings around the trachea to keep it open
stenting
What are the common causes of nasa disease in dogs
Fb
Tumour
Aspergillosis
Chronic rhinitis e.g. allergic or dental disease
What are the common causes of epistaxis in dogs
Nasal disease
Coagulopathy
How do we investigate nasal disease
CT scan
Rhinoscopy
Radiography
Nasal flush
What are the common causes of chronic rhinitis in cats
Tumours
Polyps
Rhinitis
Foreign bodies
Undiagnosed
