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Brunner A, Underberg J, Zimmermann J, Vincenti S. Comparison of the Trachea in Normocephalic versus Brachycephalic Cats on the Basis of CT-Derived Measurements. Vet Sci 2023; 10:602. [PMID: 37888554 PMCID: PMC10610650 DOI: 10.3390/vetsci10100602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/16/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Tracheal hypoplasia is a major concern in brachycephalic dogs, but there is no consensus for the trachea in brachycephalic cats. We aimed to compare tracheal length and diameter between normo- and brachycephalic cats using computed tomography (CT) image measurements and evaluate their usefulness in tracheostomy planning. A total of 15 normocephalic and 14 brachycephalic cats were included in the study. Tracheas of normocephalic cats were significantly longer compared with brachycephalic cats. No difference was detected in tracheal diameter between normocephalic and brachycephalic cats. Both groups had a lateral diameter significantly larger than the dorsoventral diameter at the level of the cranial end of the manubrium sterni and at the level of the second rib. Normocephalic and brachycephalic cats' tracheas have the same dorsoventral flattening at the level of the cranial end of the manubrium sterni and at the level of the second rib. The location between the 4th and 5th cervical vertebrae seems the best place to perform a tracheostomy in cats due to its round shape and easily accessible anatomical location. No sign of tracheal hypoplasia in brachycephalic cats was detected. Finally, 7 mm appears to be an adequate diameter for the tracheal tubes used to perform feline tracheostomies.
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Affiliation(s)
- Anna Brunner
- Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland; (A.B.); (J.Z.)
| | - Julius Underberg
- Division of Small Animal Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland;
| | - Jeannette Zimmermann
- Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland; (A.B.); (J.Z.)
| | - Simona Vincenti
- Division of Small Animal Surgery, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland; (A.B.); (J.Z.)
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Mostafa AA, Berry CR. Radiographic determination of the tracheal indices at caudal cervical, thoracic-inlet, and intra-thoracic trachea in non-bulldog brachycephalic breeds without evidence of cardiorespiratory disease. BMC Vet Res 2023; 19:184. [PMID: 37784125 PMCID: PMC10544603 DOI: 10.1186/s12917-023-03730-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/13/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Congenital tracheal hypoplasia is a component of airway syndrome affecting a wide variety of brachycephalic dog breeds. Several radiographic procedures were utilized to assess vertical tracheal diameter (VTD) in dogs. The objective of this study was to calculate the tracheal indices at the caudal cervical, thoracic-inlet, and intra-thoracic tracheal regions on the right lateral thoracic radiograph to further establish a screening protocol for diagnosis of tracheal hypoplasia in non-bulldog brachycephalic breeds. Dogs without clinical or radiographic evidence of tracheal, respiratory, or cardiovascular abnormalities were investigated. The absolute and average VTDs were normalized by manubrium length (ML), thoracic-inlet distance (Ti-D), and proximal 3rd rib width (PR3-W). Manubrium-tracheal index (M-TI), thoracic inlet-tracheal index (Ti-TI), and proximal R3-tracheal score (PR3-TS) were calculated. Correlations between averaged VTD and each of the normalizing parameters (ML, Ti-D, and PR3-W), and between M-TI and each of the previously established procedures (Ti-TI and PR3-TS) were determined. RESULTS Eighty healthy subjects met the inclusion criteria for the study. There were significant differences (P ≤ 0.0001) among the means of absolute and normalized VTDs at the 3 tracheal levels. The smallest VTD was identified at the thoracic inlet. The average tracheal diameter showed a better correlation with ML (rs=0.81, P < 0.0001) compared to Ti-D and PR3-W. There was a strong correlation (rs=0.83, P < 0.0001) between the averaged M-TI and Ti-TI. CONCLUSION Radiographic M-TI could be an alternative to traditional procedures to assess the tracheal lumen in non-bulldog brachycephalic dogs. M-TI < 0.39, < 0.30, or < 0.34 at caudal cervical, thoracic inlet, or intrathoracic trachea, respectively, may indicate tracheal hypoplasia in non-bulldog brachycephalic breeds. Screening of tracheal diameter using M-TI should be recommended. However, further investigation of non-bulldog brachycephalic breeds with cardiac and/or respiratory disease is indicated.
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Affiliation(s)
- Ayman A. Mostafa
- Department of Small Animal Surgery, Faculty of Veterinary Medicine, Cairo University, Giza, 12211 Egypt
| | - Clifford R. Berry
- Diagnostic Imaging, Department of MBS, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606 USA
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Zimmermann J, Brunner A, Underberg J, Vincenti S. CT measurements of tracheal diameter and length in normocephalic cats. J Feline Med Surg 2023; 25:1098612X231158578. [PMID: 36920794 PMCID: PMC10812007 DOI: 10.1177/1098612x231158578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
OBJECTIVES The aim of this study was to measure the tracheal dimensions of normocephalic cats using CT. METHODS CT images of 15 client-owned normocephalic cats were retrospectively evaluated to measure the length of the feline trachea. Transverse and vertical inner diameters were measured in five different tracheal regions, and the cross-sectional area of the tracheal lumen was calculated for each point of measurement. Descriptive statistics were applied using a two-tailed t-test. RESULTS The mean ± SD length of the trachea was 125.13 ± 14.41 mm. Male cats had significantly larger tracheas than female cats. The transverse diameter first increased by 0.94 mm between the most cranial point of measurement and the middle of the trachea. It then decreased by 1.38 mm between the middle of the trachea and the most caudal point of measurement. The vertical diameter decreased by 1.16 mm between the first point of measurement and the penultimate point, and then increased by 0.06 mm between the penultimate point of measurement and the end of the trachea. The two different diameters resulted in an elliptical trachea shape. CONCLUSIONS AND RELEVANCE The feline trachea was circular only at its cranial and caudal ends, and elliptical with a dorsoventral flattening along the rest of its length. Vertical and transverse diameters varied along the entire length. Tracheal shape differences should be considered when performing permanent tracheostomy, tracheal anastomosis or stenting in cats.
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Affiliation(s)
- Jeannette Zimmermann
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Anna Brunner
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Julius Underberg
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Simona Vincenti
- Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Hardjo S, Haworth M, Croton C, Purcell S, Goodwin W. Pre-hospital emergency cricothyrotomy in dogs part 2: Airway sealing and ventilation using cricothyrotomy tubes. Front Vet Sci 2023; 10:1129462. [PMID: 36876002 PMCID: PMC9981793 DOI: 10.3389/fvets.2023.1129462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Cricothyrotomy (CTT) has been recommended for use in the pre-hospital setting for military working dogs and Operational K9s during airway emergencies. Although the CTT can establish a patent airway for spontaneous ventilation, the ability to seal the airway and provide positive pressure ventilation (PPV) using tubes designed for humans has not been determined. Using various CTT tubes placed in cadaver dog airways, this study aimed to determine: (1) Whether the tube cuff could create a functional airway seal with safe intra-cuff pressures; (2) The magnitude of delivered tidal volume (TV) loss during a standard breath to assess the possibility of delivering an adequate tidal volume with a bag-valve device (BVM); (3) The best performing tubes for either test; (4) The reasons behind the findings using observations from upper airway endoscopy, dissection, and measurements. Cadaver dogs of similar weights to MWD and Operational K9 breeds had various CTT tubes placed including three from commercial kits, a standard endotracheal tube, and a tracheostomy tube. The minimum occlusive volume technique was used to inflate the tube cuff and a pressure ≤ 48 cm H2O with an adequate seal was considered successful. Individual TVs were calculated for each dog and added to the volume lost during delivery of a standard breath from an ICU ventilator. Endoscopy and airway dissection were performed to assess the relationship between tubes cuffs and the airway. The tubes from the CTT kits performed poorly with regards to producing an airway seal with the H&H tube failing to seal the airway all tests. Tracheal dimensions were significantly associated with successful airway sealing (P = 0.0004). Tidal volume loss could be compensated using a BVM in 34/35 tests with the H&H tube in cadaver 8 the only to fail. Tracheal airway sealing is influenced by airway anatomy when tube cuffs are inflated to a target pressure and larger tubes do not always provide a better seal. The CTT tubes tested have the potential to facilitate ventilation with a BVM under the conditions set in this study. The 8.0 mm endotracheal tube performed the best and the H&H the worst in both tests.
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Affiliation(s)
- Sureiyan Hardjo
- Faculty of Science, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Mark Haworth
- Faculty of Science, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Catriona Croton
- Faculty of Science, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Sarah Purcell
- Faculty of Science, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Wendy Goodwin
- Faculty of Science, School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
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Ševčíková MK, Ševčík K, Figurová M, Agyagosová-Valenčáková A, Hluchý M, Horňáková L, Lapšanská M, Kerekes Z, Žert Z. Retrospective analysis of tracheal hypoplasia in brachycephalic and non-brachycephalic dogs: Inter- and intra-observer agreement of measurements. Acta Vet Hung 2022; 70:192-200. [PMID: 36057869 DOI: 10.1556/004.2022.00018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 07/21/2022] [Indexed: 11/19/2022]
Abstract
This retrospective study was undertaken on the records of intraluminal diameter of the trachea in 185 dogs, in which hypoplasia of the trachea had been suspected. The relative size of the trachea was measured using the tracheal diameter (TD), thoracic inlet distance (TI), thoracic tracheal diameter (TT) and the width of the third rib (3R), expressed as ratios TD:TI and TT:3R. Thirty-five dogs were diagnosed as having tracheal hypoplasia. Bulldogs and non-bulldog brachycephalic dogs had significantly smaller measured trachea diameters compared to the predicted values calculated on the basis of their body weight. Radiographs of each dog were investigated by four observers. Inter- and intra-observer reliability (ICCinter, ICCintra) was based on the measurements taken by four observers to evaluate the reproducibility of the protocol. There was a good ICCinter (0.8) and ICCintra (0.89) agreement. Craniocaudal tangential radiographs, centred on the cranial thoracic aperture, did not show a significant difference in tracheal diameter measurements compared to the right lateral radiographs. In conclusion, our findings indicate that bulldogs and non-bulldog brachycephalic dogs have smaller tracheal diameters than non-brachycephalic dogs.
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Affiliation(s)
- Marieta K Ševčíková
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | - Karol Ševčík
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | - Mária Figurová
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | | | - Marián Hluchý
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | - L'ubica Horňáková
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | - Mária Lapšanská
- 1 Small Animal Clinic, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81 Košice, Slovakia
| | - Zoltán Kerekes
- 2 Clinic of Horses, University of Veterinary Medicine and Pharmacy, Komenského 73, 041 81, Košice, Slovakia
- 4 VetScan Pet Diagnostics, Budapest, Hungary
| | - Zdeněk Žert
- 3 University of Veterinary Medicine Budapest, Budapest, Hungary
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Radiographic vertical tracheal diameter assessment at different levels along the trachea as an alternative method for the evaluation of the tracheal diameter in non-brachycephalic small breed dogs. BMC Vet Res 2022; 18:61. [PMID: 35105371 PMCID: PMC8805285 DOI: 10.1186/s12917-022-03160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background Tracheal narrowing due to congenital tracheal hypoplasia, acquired tracheal stenosis and tracheal collapse can lead to life-threatening respiratory distress. Tracheal hypoplasia has been identified in brachycephalic dog breeds, predominantly English Bulldogs, by measuring the tracheal diameter compared to the diameter of the thoracic inlet and creating a ratio. However, reference ranges for tracheal diameter have not been established for non-brachycephalic small breed dogs. It would be advantageous to have established tracheal diameters for non-brachycephalic small breed dogs, as these are the dogs most at risk of tracheal collapse. The main objective, of this study was to radiographically evaluate vertical tracheal diameter (VTD) at three standardized locations along the trachea of non-brachycephalic small breed dogs, in an attempt to further establish a screening diagnostic protocol for canine tracheal hypoplasia. Medical records and thoracic radiographs of non-brachycephalic small breed dogs without respiratory disease were reviewed. Right lateral radiographs were reviewed. The absolute and average VTDs at three locations (location A: caudal cervical VTD; location B thoracic inlet VTD; location C: intrathoracic VTD) were standardized by manubrium length (ML), as well as by the previously utilized thoracic inlet distance (Ti-D) and proximal 3rd rib width (PR3-W) to calculate manubrium-tracheal index (M-TI), thoracic inlet-tracheal index (Ti-TI), and proximal R3-tracheal score (PR3-TS), respectively. Correlations between averaged tracheal diameter and each of the ML, Ti-D, and PR3-W, and between M-TI and each of Ti-TI and PR3-TS were calculated. Results Eighty-one healthy dogs met the criteria for inclusion. Significant differences (P < 0.0001) were identified among the mean values of the absolute and standardized VTDs at levels A, B, and C. The smallest tracheal diameter was identified at the level of the thoracic inlet (Level B). The average VTD correlated better with ML (rs = 0.82, P < 0.0001) compared to Ti-D and PR3-W. A relatively strong correlation (rs = 0.77, P < 0.0001) was identified between the averaged manubrium tracheal index (M-TI) and thoracic inlet tracheal index (Ti-TI). Conclusion M-TI is an appropriate alternative to Ti-TI and PR3-TS to radiographically evaluate VTD in dogs. M-TI < 0.43, < 0.34, or < 0.38 at level A, B, or C, respectively, may indicate tracheal hypoplasia in non-brachycephalic small breed dogs. Screening of canine VTD could be achieved using M-TI.
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Park JH, Ahn M, Park SH, Kim H, Bae M, Park W, Hollister SJ, Kim SW, Cho DW. 3D bioprinting of a trachea-mimetic cellular construct of a clinically relevant size. Biomaterials 2021; 279:121246. [PMID: 34775331 PMCID: PMC8663475 DOI: 10.1016/j.biomaterials.2021.121246] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
Despite notable advances in extrusion-based 3D bioprinting, it remains a challenge to create a clinically-sized cellular construct using extrusion-based 3D printing due to long printing times adversely affecting cell viability and functionality. Here, we present an advanced extrusion-based 3D bioprinting strategy composed of a two-step printing process to facilitate creation of a trachea-mimetic cellular construct of clinically relevant size. A porous bellows framework is first printed using typical extrusion-based 3D printing. Selective printing of cellular components, such as cartilage rings and epithelium lining, is then performed on the outer grooves and inner surface of the bellows framework by a rotational printing process. With this strategy, 3D bioprinting of a trachea-mimetic cellular construct of clinically relevant size is achieved in significantly less total printing time compared to a typical extrusion-based 3D bioprinting strategy which requires printing of an additional sacrificial material. Tracheal cartilage formation was successfully demonstrated in a nude mouse model through a subcutaneous implantation study of trachea-mimetic cellular constructs wrapped with a sinusoidal-patterned tubular mesh preventing rapid resorption of cartilage rings in vivo. This two-step 3D bioprinting for a trachea-mimetic cellular construct of clinically relevant size can provide a fundamental step towards clinical translation of 3D bioprinting based tracheal reconstruction.
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Affiliation(s)
- Jeong Hun Park
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA
| | - Minjun Ahn
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk, 37673, Republic of Korea
| | - Sun Hwa Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-710, Republic of Korea
| | - Hyeonji Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk, 37673, Republic of Korea
| | - Mihyeon Bae
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk, 37673, Republic of Korea
| | - Wonbin Park
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk, 37673, Republic of Korea
| | - Scott J Hollister
- Wallace H. Coulter Department of Biomedical Engineering and Center for 3D Medical Fabrication, Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA, 30332, USA.
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 137-710, Republic of Korea.
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, Pohang, Kyungbuk, 37673, Republic of Korea.
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Haider G, Lorinson K, Lorinson D, Auer U. Development of a clinical tool to aid endotracheal tube size selection in dogs. Vet Rec 2019; 186:157. [PMID: 31530720 DOI: 10.1136/vr.105065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/30/2019] [Accepted: 08/28/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To identify phenotypic parameters correlating with the inner tracheal diameter (ITD) and endotracheal tube size (ETS) in adult dogs and to develop a chart for ETS estimation. METHODS Five-hundred and forty-four adult dogs; 100 dogs were enrolled prospectively and 444 dogs retrospectively. Different phenotypic parameters, the ITD on latero-lateral radiography and ETS were prospectively measured in dogs that underwent general anaesthesia. The parameter correlated best with the ITD was used to develop a graphic chart for ETS estimation. The accuracy of this chart was then retrospectively tested. RESULTS In prospective cohort, the correlation between body size and body mass and ITD (r=0.85 and r=0.84) was good, and the highest correlation observed between ETS and body mass (rs=0.92, P<0.001). In the retrospective assessment, the mean difference between the predicted and used ETS was 0.0 (sd±0.84) for mesocephalic/dolicocephalic (MDC) dogs, showing high accuracy, but for brachycephalic dogs, it was 1.3 (sd±0.98). CONCLUSION A graphic chart for ETS selection in dogs, using body mass, was designed in this study and was demonstrated to be accurate for ETS prediction in MDC dogs but not in brachycephalic dogs.
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Affiliation(s)
- Georg Haider
- AniCura Regionsdjursjukhuset Bagarmossen, Bagarmossen, Sweden
| | - Karin Lorinson
- Chirurgisches Zentrum für Kleintiere, Vösendorf, Austria
| | | | - Ulrike Auer
- Anaesthesia, Veterinarmedizinische Universitat Wien, Wien, Austria
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Violette NP, Weisse C, Berent AC, Lamb KE. Correlations among tracheal dimensions, tracheal stent dimensions, and major complications after endoluminal stenting of tracheal collapse syndrome in dogs. J Vet Intern Med 2019; 33:2209-2216. [PMID: 31290188 PMCID: PMC6766514 DOI: 10.1111/jvim.15555] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 06/25/2019] [Indexed: 11/30/2022] Open
Abstract
Background Endoluminal tracheal stenting can relieve signs associated with tracheal collapse syndrome (TCS) in dogs, but major complications can result. Objective To identify associations among tracheal dimensions, stent dimensions, and subsequent complications requiring additional stent placement after endoluminal stenting for TCS. Animals Fifty‐two dogs from the hospital population. Methods Medical records of dogs that received an endoluminal self‐expanding tracheal stent for TCS by the interventional radiology service between 2009 and 2014 were reviewed for relevant data. Signalment and clinical details, including tracheal collapse type, tracheal measurements, nominal stent dimensions, follow‐up evaluation times, and stent complications, were recorded. Results Fifty‐two dogs that received an endoluminal stent for TCS met the inclusion criteria. Major complications included stent fracture (13/52; 25%), obstructive tissue ingrowth (10/52; 19%), and progressive tracheal collapse (6/52; 12%). Natural tracheal taper (P = .04) and more stent diameter oversizing (P = .04) in the intrathoracic (IT) trachea were associated with caudodorsal stent fracture. Only stents with a 14‐mm nominal diameter fractured. Progressive tracheal collapse was associated with smaller maximum tracheal diameters (P = .02). The majority of dogs with obstructive tissue ingrowth (7/10; 70%; P = .30) and all dogs with thoracic inlet fractures (3/3; 100%) had tracheal malformations. Conclusions and Clinical Importance A higher taper in tracheal diameter may lead to increased risk of fracture in the IT location. Dogs with tracheal malformations may have higher risk for thoracic inlet fracture and development of obstructive tissue ingrowth. Clinicians should be aware of the possible risk factors for tracheal stent complications.
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Affiliation(s)
- Nathaniel P Violette
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Chick Weisse
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Allyson C Berent
- Department of Diagnostic Imaging and Interventional Radiology, The Animal Medical Center, New York, New York
| | - Kenneth E Lamb
- Lamb Statistical Consulting LLC, West St. Paul, Minnesota
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Soriano-Rosales RE, Pérez-Guillé BE, Jimenez-Bravo-Luna MA, Monroy-Santoyo S, Villegas-Alvarez F, Carmona-Mancilla A, Jiménez-Gutiérrez C, Elizalde-Velázquez SL, Gonzalez-Zamora JF. Tracheal growth assessment in mongrel puppies (dogs) through multidetector CT. Vet Rec Open 2018; 5:e000238. [PMID: 29632670 PMCID: PMC5888435 DOI: 10.1136/vetreco-2017-000238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/25/2018] [Accepted: 01/31/2018] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to describe the tracheal growth pattern and its zoometric relationship in related medium-sized mongrel puppies through adulthood. Fourteen puppies were studied. CT monitoring was performed monthly, starting in the 1st month of life through the 7th month and subsequently at the 9th and 12th months. Additionally, six zoometric measurements were performed. Dorsoventral (DV) and transverse (TV) diameters and the luminal area from C1 to T2 were obtained. The global tracheal growth pattern revealed an increase up to 13 times its initial size, reaching a plateau phase during the last trimester. The relationship between the DV and the TV internal diameters of the tracheal lumen did not change during growth. As previously reported, the cranial tracheal area was wider, while the caudal part gradually decreased towards T1–T2; this consideration is important since the more distal an endotracheal tube is inserted, the greater the risk that injury may occur. The linear correlation between the zoometric measurements and the tracheal ring areas was positive. This study provides evidence for the evaluation of the morphometry of the canine trachea during physiological growth using helicoidal CT as a non-invasive, accurate tool.
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Affiliation(s)
| | | | | | - Susana Monroy-Santoyo
- Experimental Surgery Laboratory, National Institute of Paediatrics, Mexico City, Mexico
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11
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Rutherford L, Beever L, Bruce M, Ter Haar G. Assessment of computed tomography derived cricoid cartilage and tracheal dimensions to evaluate degree of cricoid narrowing in brachycephalic dogs. Vet Radiol Ultrasound 2017; 58:634-646. [PMID: 28758273 DOI: 10.1111/vru.12526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 04/18/2017] [Accepted: 04/23/2017] [Indexed: 11/27/2022] Open
Abstract
The aims of this observational, analytical, retrospective study were to (i) obtain computed tomographic (CT) cricoid dimensions (height, width, and transverse-sectional area), (ii) compare the cricoid dimensions between brachycephalic and mesaticephalic breeds, and (iii) compare cricoid cartilage dimensions between dogs without and affected with brachycephalic airway syndrome. The study is important to help to further evaluate and understand the anatomical components of brachycephalic airway syndrome. Measurements were performed in 147 brachycephalic and 59 mesaticephalic dogs. The cricoid cartilage was found to be significantly more oval in Pugs and French Bulldogs compared to mesaticephalic breeds. The cricoid cartilage transverse-sectional area was smallest for the Pug and, after adjusting for weight, significantly smaller for Pugs (P < 0.001), Boston Terriers (P = 0.001), and French Bulldogs (P < 0.001) compared to Jack Russell Terriers. The tracheal transverse-sectional area at C4 of English Bulldogs was significantly smaller than for Jack Russell Terriers (P = 0.005) and Labradors (P < 0.001). The cricoid cartilage transverse-sectional area:weight ratio was significantly lower in brachycephalic breeds compared to mesaticephalic breeds (P < 0.001). The cricoid cartilage:trachea at C4 transverse-sectional area for brachycephalic dogs was significantly larger than for mesaticephalic dogs (<0.001), demonstrating that the trachea was the narrowest part of the airway. No significant differences were found for cricoid dimensions between dogs affected with and without brachycephalic airway syndrome. However, large individual variation was found among the brachycephalic breeds and further studies investigating the relationship between cricoid cartilage size, laryngeal collapse, concurrent tracheal hypoplasia, and/or severity of brachycephalic airway syndrome are warranted.
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Affiliation(s)
- Lynda Rutherford
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Lee Beever
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Mieghan Bruce
- Department of Production and Population Health, Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
| | - Gert Ter Haar
- Clinical Services Division, Royal Veterinary College, Hatfield, Hertfordshire, AL9 7TA, UK
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Basdani E, Papazoglou LG, Patsikas MN, Kazakos GM, Adamama-Moraitou KK, Tsokataridis I. Upper Airway Injury in Dogs Secondary to Trauma: 10 Dogs (2000–2011). J Am Anim Hosp Assoc 2016; 52:291-6. [DOI: 10.5326/jaaha-ms-6067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Ten dogs that presented with trauma-induced upper airway rupture or stenosis were reviewed. Tracheal rupture was seen in seven dogs, tracheal stenosis in one dog, and laryngeal rupture in two dogs. Clinical abnormalities included respiratory distress in five dogs, subcutaneous emphysema in eight, air leakage through the cervical wound in seven, stridor in three dogs, pneumomediastinum in four and pneumothorax in one dog. Reconstruction with simple interrupted sutures was performed in four dogs, tracheal resection and end-to-end anastomosis in five dogs, and one dog was euthanized intraoperatively. Complications were seen in three dogs including aspiration pneumonia in one and vocalization alterations in two dogs.
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Affiliation(s)
- Eleni Basdani
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
| | - Lysimachos G. Papazoglou
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
| | - Michail N. Patsikas
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
| | - Georgios M. Kazakos
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
| | - Katerina K. Adamama-Moraitou
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
| | - Ioannis Tsokataridis
- From the Department of Clinical Sciences, Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (L.G.P., E.B., M.N.P., G.M.K., K.K.A-M.); and Private Practice, Drama, Greece (I.T.)
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13
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Williams JM, Krebs IA, Riedesel EA, Zhao Q. COMPARISON OF FLUOROSCOPY AND COMPUTED TOMOGRAPHY FOR TRACHEAL LUMEN DIAMETER MEASUREMENT AND DETERMINATION OF INTRALUMINAL STENT SIZE IN HEALTHY DOGS. Vet Radiol Ultrasound 2016; 57:269-75. [PMID: 26784924 DOI: 10.1111/vru.12344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 11/09/2015] [Accepted: 11/11/2015] [Indexed: 11/27/2022] Open
Abstract
Tracheal collapse is a progressive airway disease that can ultimately result in complete airway obstruction. Intraluminal tracheal stents are a minimally invasive and viable treatment for tracheal collapse once the disease becomes refractory to medical management. Intraluminal stent size is chosen based on the maximum measured tracheal diameter during maximum inflation. The purpose of this prospective, cross-sectional study was to compare tracheal lumen diameter measurements and subsequent selected stent size using both fluoroscopy and CT and to evaluate inter- and intraobserver variability of the measurements. Seventeen healthy Beagles were anesthetized and imaged with fluoroscopy and CT with positive pressure ventilation to 20 cm H2 O. Fluoroscopic and CT maximum tracheal diameters were measured by three readers. Three individual measurements were made at eight predetermined tracheal sites for dorsoventral (height) and laterolateral (width) dimensions. Tracheal diameters and stent sizes (based on the maximum tracheal diameter + 10%) were analyzed using a linear mixed model. CT tracheal lumen diameters were larger compared to fluoroscopy at all locations (P-value < 0.0001). When comparing modalities, fluoroscopic and CT stent sizes were statistically different. Greater overall variation in tracheal diameter measurement (height or width) existed for fluoroscopy compared to CT, both within and among observers. The greater tracheal diameter measured with CT and lower measurement variability has clinical significance, as this may be the imaging modality of choice for appropriate stent selection to minimize complications in veterinary patients.
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Affiliation(s)
- Jackie M Williams
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Ingar A Krebs
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Elizabeth A Riedesel
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, 50010
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, 53792
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Kaye BM, Boroffka SAEB, Haagsman AN, Haar GT. COMPUTED TOMOGRAPHIC, RADIOGRAPHIC, AND ENDOSCOPIC TRACHEAL DIMENSIONS IN ENGLISH BULLDOGS WITH GRADE 1 CLINICAL SIGNS OF BRACHYCEPHALIC AIRWAY SYNDROME. Vet Radiol Ultrasound 2015. [DOI: 10.1111/vru.12277] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Benjamin M. Kaye
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL97TA UK
| | - Susanne A. E. B. Boroffka
- Division of Diagnostic Imaging; Faculty of Veterinary Medicine, Utrecht University; Yalelaan 108, 3584 CM Utrecht The Netherlands
| | - Annika N. Haagsman
- Department of Veterinary Clinical Sciences; Faculty of Veterinary Medicine, Utrecht University; Yalelaan 108, 3584 CM Utrecht The Netherlands
| | - Gert Ter Haar
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; Hawkshead Lane, North Mymms Hatfield Hertfordshire AL97TA UK
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Clinical and biological acceptance of a fibrocollagen-coated mersylene patch for tracheal repair in growing dogs. The Journal of Laryngology & Otology 2014; 128:630-40. [PMID: 25075948 DOI: 10.1017/s0022215114001339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Collagen-covered prostheses can be used as a non-circumferential segmental tracheal replacement. However, the applicability of these implants in young subjects has not yet been reported. METHODS In this experimental, longitudinal study, dogs aged 29-32 days underwent limited segmental tracheal replacement with a polyester prosthesis or were allocated to a control, untreated group. The dogs were evaluated clinically, endoscopically and tomographically for up to one year. RESULTS Although there was evidence of tracheal growth in the experimental group, tomographic measurements were significantly smaller in this group than in the control group throughout the observation period. At the end of the study, there was no evidence of implant rejection, stenosis or collapse. Normal respiratory epithelium had grown across the implanted membrane in the experimental group. CONCLUSION The homologous collagen mersylene membrane allowed for limited structural tracheal growth and was functionally integrated into the segmented tracheal wall in growing dogs.
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Montgomery JE, Mathews KG, Marcellin-Little DJ, Hendrick S, Brown JC. Comparison of Radiography and Computed Tomography for Determining Tracheal Diameter and Length in Dogs. Vet Surg 2014; 44:114-8. [DOI: 10.1111/j.1532-950x.2014.12227.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 05/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- James E. Montgomery
- Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SK Canada
| | - Kyle G. Mathews
- College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina
| | | | - Steve Hendrick
- Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon SK Canada
| | - James C. Brown
- College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina
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Leonard CD, Johnson LR, Bonadio CM, Pollard RE. Changes in tracheal dimensions during inspiration and expiration in healthy dogs as detected via computed tomography. Am J Vet Res 2009; 70:986-91. [DOI: 10.2460/ajvr.70.8.986] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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