URT Surgery Flashcards
What is stertor?
Low snoring sound on inspiration
Common in BOAS cases
Sign of URT pathology
Caused by long soft palate and laryngeal saccule eversion
Primary BOAS pathophysiology factors
Stenotic nares
Relative over length of soft palate
Sliding hiatal hernia
Tracheal hypoplasia/stenosis
Relative oversized tongue
Secondary BOAS pathophysiology factors
Everted laryngeal saccules
Laryngeal collapse
Pharyngeal collapse
Glosso-epiglottic mucose displacement
Scrolling of epiglottic cartilage
Vomiting/regurgitaiton
Tonsillar hypertrophy
What is stridor?
High pitched wheezing on inspiration (sometimes on expiration)
Caused by laryngeal obstruction (paralysis) or tracheal collapse
What are the stages of laryngeal collapse?
Stage 1 - laryngeal saccule eversion
Stage 2 - medial deviation of cuneiform cartilage and aryepiglottic fold/ collapse
Stage 3 - medial deviation of corniculate cartilage /collapse
Treatment for laryngeal collapse
Excision of everted laryngeal saccules
Treatment for stenotic nares
Rhinoplasty - wedge resection
(Doesn’t take away alar fold)
Leipzig method involves alar fold resection
Methods of soft palate surgery
Partial staphyhylectomy
Folded-flap Platoplasty
What is Partial staphyhylectomy and why is it used?
When an animal has excessive soft palate (due to shortened maxilla) which obstructs laryngeal aperture (rima glottis)
Partial resection of excessive soft palate
Animal will be internal recumbency
What is folded-flap palatoplasty?
U shape incision to produce a fold of palate which is thinned and pulled forward to shorten
Clinical sign of laryngeal paralysis
Stridor
Cough
Dyspnoea
Change in bark
Exercise intolerance
Causes of laryngeal collapse
Neurogenic atrophy of the intrinsic laryngeal muscles
Congenital or acquired
Dysfunction of the recurrent laryngeal nerves
Generalised peripheral neuropathy involving long and large diameter nerve fibres
Central nervous system origin
Hypothyroidism
Often older aged large breed dogs
How can you diagnose laryngeal collapse?
Characteristic clinical signs
Auscultation of larynx and pharynx
laryngoscopy under GA
Surgery radiographs
Neurological exam
Concurrent disease of laryngeal collapse
Dysphagia
Megaoesophagus
Lower respiratory tract disease
Cardiac disease
Emergency management of laryngeal collapse
Rest
Supplementary oxygen
Cooling
Sedation
IV access
IV corticosteroids
Anaesthesia = Tracheostomy
NEEDS SURGERY
