1
|
Lai GP, Grimes JA, Wallace ML, Schmiedt CW, Savage MY. Anatomic characterization of the location of the esophageal ostium relative to the rima glottidis on CT in adult Labrador Retrievers. Am J Vet Res 2021; 82:975-980. [PMID: 34714769 DOI: 10.2460/ajvr.20.11.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To characterize the anatomic location of the esophageal ostium relative to the rima glottidis in adult Labrador Retrievers with the use of CT. ANIMALS 98 CT scans of 75 adult Labrador Retrievers. PROCEDURES A search of the medical records database identified records of Labrador Retrievers that underwent CT of the head and neck between January 1, 2015, and December 31, 2018. Evaluators, blinded to each other's results, reviewed CT images and measured esophageal area at the level of the rima glottidis. For each dog, the left esophageal percentage (LEP) was calculated as the esophageal area left of the rima glottidis midline divided by the overall esophageal area at that level. Variables (age, sex, patient position, intubation status, and maxillary support during CT) were evaluated for association with LEP. The CT images of dogs that had multiple scans were assessed for within-patient variance. RESULTS Mean LEP was 56.2 ± 18.1% for all dogs. Only right lateral recumbency was significantly associated with LEP, with a lower LEP for dogs positioned in right lateral recumbency (42.4 ± 12.7%), compared with left lateral (63.0 ± 7.4%) or sternal (57.3 ± 18.8%) recumbency. No association was detected between LEP and other variables assessed. Eleven dogs had multiple CT scans; within-patient variance for LEP was ± 26.6%. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, although most dogs had an LEP > 50%, the esophageal ostium was fairly centrally located in most dogs and may be more mobile than previously thought. Additional research is warranted to assess this mobility and whether the esophageal ostium location, relative to the larynx, affects the incidence of aspiration pneumonia in dogs undergoing surgical treatment for geriatric-onset laryngeal paralysis and polyneuropathy.
Collapse
Affiliation(s)
- Grace P Lai
- From the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
| | - Janet A Grimes
- From the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
| | - Mandy L Wallace
- From the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
| | - Chad W Schmiedt
- From the Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602
| | | |
Collapse
|
2
|
Martin‐Flores M, Sakai DM, Cheetham J. Quantitative assessment of progressive laryngeal hemiplegia in a 4‐year‐old beagle. VETERINARY RECORD CASE REPORTS 2021; 10. [DOI: 10.1002/vrc2.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Manuel Martin‐Flores
- Department of Clinical Sciences College of Veterinary Medicine Cornell University Ithaca New York USA
| | - Daniel M. Sakai
- Department of Clinical Sciences College of Veterinary Medicine Cornell University Ithaca New York USA
| | - Jonathan Cheetham
- Department of Clinical Sciences College of Veterinary Medicine Cornell University Ithaca New York USA
| |
Collapse
|
3
|
Rishniw M, Sammarco J, Glass EN, Cerroni B. Effect of doxepin on quality of life in Labradors with laryngeal paralysis: A double-blinded, randomized, placebo-controlled trial. J Vet Intern Med 2021; 35:1943-1949. [PMID: 33998727 PMCID: PMC8295677 DOI: 10.1111/jvim.16162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background Laryngeal paralysis commonly affects older Labrador retrievers. Currently, dogs with severe disease require surgical intervention, most commonly arytenoid lateralization. Anecdotally, doxepin has been proposed to help dogs with laryngeal paralysis. Hypothesis Doxepin will improve quality of life measures assessed by owners of Labrador retrievers with laryngeal paralysis not requiring emergency surgery. Animals Twenty‐two Labrador retrievers with laryngeal paralysis. Methods Dogs were randomized to receive doxepin (3‐5 mg/kg q12h PO) or placebo for 28 days. Owners completed quality‐of‐life assessments before and after completing the study. Data were compared between groups using Rank‐Sum tests or Fisher's exact tests. Results The 2 groups of dogs did not differ at baseline except for owner‐perceived degree of ataxia (owners of dogs receiving doxepin considered them more ataxic than owners of dogs receiving placebo). After 28 days, owner‐assessed quality of life measures did not differ between dogs receiving doxepin or placebo (dogs worsening: doxepin = 2, placebo = 1; dogs unchanged: doxepin = 6, placebo = 7; dogs improved: doxepin = 4, placebo = 2; P = .84). Dogs receiving placebo had a greater improvement in client‐assessed overall health than dogs receiving doxepin (mean ranks: doxepin = 4.36, placebo = 6.64; P = .04). The study was terminated at this interim analysis. Conclusions and Clinical Importance Doxepin did not appear to improve any measures of owner‐assessed quality of life in Labrador retrievers with laryngeal paralysis.
Collapse
Affiliation(s)
- Mark Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Jill Sammarco
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, USA
| | - Eric N Glass
- Red Bank Veterinary Hospital, Tinton Falls, New Jersey, USA
| | | |
Collapse
|
4
|
Sample SJ, Hardie RJ, Stein J, Webb J. Evaluation of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis. Res Vet Sci 2017; 117:239-245. [PMID: 29324376 DOI: 10.1016/j.rvsc.2017.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 12/06/2017] [Accepted: 12/14/2017] [Indexed: 11/29/2022]
Abstract
The aim of this experimental study was to evaluate the effect of Translaryngeal Percutaneous Arytenoid Lateralization (TPAL) in dogs with experimentally created laryngeal paralysis. All dogs (n=5) underwent bilateral recurrent laryngeal neurectomy before TPAL. Two TPAL suture techniques were evaluated. TPAL-CranialCaudal (TPAL-CC) was performed first, followed 11 to 14days later by TPAL-DorsalVentral (TPAL-DV). For both techniques, a mattress suture was placed through the arytenoid cartilage via an oral approach. Laryngeal examination was performed before, immediately after, and on days 1, 3 and 7 for both TPAL techniques. Ipsilateral hemiglottic surface area and the degree of laryngeal swelling or reaction to the suture were recorded. Laryngeal tissue was evaluated by histopathology at the end of the study. For both TPAL techniques, hemiglottic surface area was increased immediately after suture placement (P<0.05). At all other times, hemiglottic area was not statistically different from preoperative value (P>0.05). TPAL-DV resulted in less laryngeal swelling compared to TPAL-CC. Histopathology of the arytenoid cartilage surrounding the mattress suture revealed mucosal ulceration and inflammation consistent with the presence of the suture material. Both TPAL techniques were effective at lateralizing the arytenoid cartilage and significantly increasing hemiglottic surface area immediately after suture placement. However, mucosal swelling and loss of tension on the mattress suture lead to a decrease in glottic area within 24h. Further refinements in suture placement technique are warranted to minimize swelling and improve the duration of arytenoid lateralization prior to clinical application.
Collapse
Affiliation(s)
- Susannah J Sample
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Robert J Hardie
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States.
| | - John Stein
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| | - Julie Webb
- School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706, United States
| |
Collapse
|
5
|
Ganjei J, Langenbach A, Watrous G, Hodgson J. Comparison of bacterial cultures of the larynx between dogs with laryngeal paralysis and normal dogs. J Small Anim Pract 2016; 57:644-649. [PMID: 27739066 DOI: 10.1111/jsap.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 06/28/2016] [Accepted: 07/25/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To document the most common types of bacteria isolated from the canine larynx and to compare isolates, degree of growth and susceptibility patterns between dogs with laryngeal paralysis and dogs with normal laryngeal function. METHODS Laryngeal swabs were collected from each patient and submitted for bacterial culture and susceptibility testing. Dogs with laryngeal paralysis (n=23) underwent a unilateral arytenoid lateralisation and control dogs (n=24) underwent an elective orthopaedic procedure. Results of the cultures were compared between groups. RESULTS Bacterial organisms isolated from the larynx were similar to those normally found in the oropharynx, trachea and lungs. The most common bacteria isolated from the larynges of all dogs were Escherichia coli, Klebsiella species and Pasteurella species. Pure colonies were more commonly seen in dogs with laryngeal paralysis while mixed colonies were more commonly seen in control dogs. Antimicrobial resistance was similar between study and control dogs. CLINICAL SIGNIFICANCE The laryngeal flora appears to contain bacteria that are commonly isolated from the oropharynx, trachea and lungs. Differences in antimicrobial susceptibility were not identified between study and control dogs.
Collapse
Affiliation(s)
- J Ganjei
- Department of Surgery, Veterinary Surgical Centers, Vienna, VA 22180, USA.
| | - A Langenbach
- Department of Surgery, Veterinary Surgical Centers, Vienna, VA 22180, USA
| | - G Watrous
- Department of Surgery, Ontario Veterinary College, Guelph, ON N1G 2W1, Canada
| | - J Hodgson
- Department of Microbiology, Virginia-Maryland College of Veterinary Medicine, Blacksburg, VA 24060, USA
| |
Collapse
|
6
|
|
7
|
Milovancev M, Townsend K, Spina J, Hurley C, Ralphs SC, Trumpatori B, Seguin B, Jermyn K. Effect of Metoclopramide on the Incidence of Early Postoperative Aspiration Pneumonia in Dogs with Acquired Idiopathic Laryngeal Paralysis. Vet Surg 2016; 45:577-81. [DOI: 10.1111/vsu.12491] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/16/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Milan Milovancev
- Department of Clinical Sciences; College of Veterinary Medicine, Oregon State University; Corvallis Oregon
| | - Katy Townsend
- Department of Clinical Sciences; College of Veterinary Medicine, Oregon State University; Corvallis Oregon
| | - Jason Spina
- Department of Clinical Sciences; College of Veterinary Medicine, Oregon State University; Corvallis Oregon
| | - Connie Hurley
- Wisconsin Veterinary Referral Center; Waukesha Wisconsin
| | | | - Brian Trumpatori
- Veterinary Specialty Hospital of the Carolinas; Cary North Carolina
| | - Bernard Seguin
- Department of Clinical Sciences; College of Veterinary Medicine, Oregon State University; Corvallis Oregon
| | - Kieri Jermyn
- Department of Clinical Sciences; College of Veterinary Medicine, North Carolina State University; Raleigh North Carolina
| |
Collapse
|
8
|
Bookbinder LC, Flanders J, Bookbinder PF, Harvey HJ, Barry JS, Cheetham J. Idiopathic Canine Laryngeal Paralysis as One Sign of a Diffuse Polyneuropathy: An Observational Study of 90 Cases (2007-2013). Vet Surg 2016; 45:254-60. [PMID: 26757180 DOI: 10.1111/vsu.12444] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine survival and incidence of complications in dogs with idiopathic laryngeal paralysis (ILP) and concurrent neurologic signs. STUDY DESIGN Observational study. ANIMALS Dogs (n = 90) with ILP. METHODS Medical records (January 2007-June 2013) of dogs with ILP were reviewed. Neurologic comorbidities, including pelvic limb neurologic abnormalities and esophageal abnormalities were identified. Using medical record information and client interviews, the relationship between these comorbidities and postoperative survival (primary outcome measure) and postoperative complications (secondary outcome measure) was identified. RESULTS Dogs that had surgical correction of ILP had a 2.6-fold reduction in the hazard of death throughout the study period (HR = 2.6; 95% CI: 1.34-4.84, P = .006). Owner assessed patient quality of life (10-point scale) increased by an average of 4.1 ± 1.4 units immediately postoperatively, and 4.9 ± 0.9 units until death or followup compared with preoperative values. Thirty-five of 72 dogs available for followup had evidence of diffuse neurologic comorbidities. Overall complication rate for dogs with neurologic comorbidities was 74%, compared with 32% for dogs without neurologic comorbidities. Presence of any neurologic comorbidity was associated with a significantly greater odds of any complication (OR = 4.04; 95% CI: 1.25-13.90, P = .019) as well as recurring complications (OR = 8.00; 95% CI: 1.49-54.38; P = .015). CONCLUSION Surgical correction of ILP was positively associated with survival, and dogs with neurologic comorbidities were at greater risk for developing postoperative complications.
Collapse
Affiliation(s)
- Lauren C Bookbinder
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - James Flanders
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Paul F Bookbinder
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - H Jay Harvey
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Jay S Barry
- Cornell Statistical Consulting Unit, Cornell University, Ithaca, New York
| | - Jon Cheetham
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| |
Collapse
|
9
|
Shipov A, Israeli I, Weiser M, Kelmer E, Klainbart S, Milgram J. Minimally invasive unilateral arytenoid lateralization in dogs: A cadaveric study. Res Vet Sci 2015; 102:112-7. [PMID: 26412529 DOI: 10.1016/j.rvsc.2015.07.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Revised: 07/13/2015] [Accepted: 07/26/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to develop a minimally invasive thyroarytenoid lateralization technique (MITAL). Eleven unilateral MITAL procedures were performed on 11 canine cadavers. Two hypodermic needles were passed through the skin into the lumen of the larynx, penetrating the thyroid and arytenoid cartilages. Suture material was passed through the needles to lateralize the arytenoid cartilage. A rigid endoscope was used to visualize needle insertion and suture material placement. A key-hole approach to the larynx was performed and the suture material was knotted on the lateral aspect of the thyroid cartilage. The change in the rima glottidis area was recorded as were the duration of the procedure and complications encountered. The landmarks for needle insertion were easily palpated, and a significant increase in the area of the rima glottidis was documented after performing unilateral MITAL. In conclusion, unilateral MITAL is a quick, minimally invasive procedure which increases the area of the rima glottidis in cadaveric dogs.
Collapse
Affiliation(s)
- A Shipov
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - I Israeli
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - M Weiser
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - E Kelmer
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - S Klainbart
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel
| | - J Milgram
- Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, P.O. Box 12, Rehovot 76100, Israel.
| |
Collapse
|
10
|
Stegen L, Kitshoff AM, Van Goethem B, Vandekerckhove P, de Rooster H. Intralaryngeal thyroarytaenoid lateralisation using the Fast-Fix 360 system: a canine cadaveric study. Vet Rec Open 2015; 2:e000125. [PMID: 26392907 PMCID: PMC4567165 DOI: 10.1136/vetreco-2015-000125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 06/17/2015] [Accepted: 06/29/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction Laryngeal paralysis is a condition in which failure of arytaenoid abduction results in a reduced rima glottidis cross-sectional area. The most commonly performed surgical techniques rely on unilateral abduction of the arytaenoid, requiring a lateral or ventral surgical approach to the larynx. Aims and objectives The aim of the study was to investigate a novel minimally invasive intralaryngeal thyroarytaenoid lateralisation technique, using the Fast-Fix 360 meniscal repair system. Materials and methods Larynges were harvested from large breed canine cadavers. With the aid of Kirschner wires placed between the centre of the vocal process and the centre of an imaginary line between the cranial thyroid fissure and the cricothyroid articulation, the mean insertion angle was calculated. Results The Fast-Fix 360 delivery needle inserted intralaryngeally (n=10), according to a simplified insertion angle (70°), resulted in thyroid penetration (>2.5 mm from margin) in all patients. The Fast-Fix was applied unilaterally at 70° with the first toggle fired on the lateral aspect of the thyroid cartilage and inside the laryngeal cavity on retraction. The suture was tightened. Preprocedural (61.06±9.21 mm2) and postprocedural (138.37±26.12 mm2) rima glottidis cross-sectional area was significantly different (P<0.0001). The mean percentage increase in rima glottidis cross-sectional area was 125.96 per cent (±16.54 per cent). Conclusion Intralaryngeal thyroarytaenoid laterlisation using the Fast-Fix 360 meniscal repair system ex vivo increased the rima glottidis cross-sectional area significantly.
Collapse
Affiliation(s)
- Ludo Stegen
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, University of Ghent, 133 Salisburylaan, Merelbeke, 9820, Belgium ; Tiergesundheitszentrum Gruβendorf Tierärztliche Klinik für Kleintiere, 2 Wiechmanns Eck 2, Bramsche, 49565, Germany
| | - Adriaan M Kitshoff
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, University of Ghent, 133 Salisburylaan, Merelbeke, 9820, Belgium
| | - Bart Van Goethem
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, University of Ghent, 133 Salisburylaan, Merelbeke, 9820, Belgium
| | | | - Hilde de Rooster
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, University of Ghent, 133 Salisburylaan, Merelbeke, 9820, Belgium
| |
Collapse
|
11
|
Abstract
The most common disease process involving the larynx is laryngeal paralysis, which occurs much more frequently in dogs than in cats. Diagnosis of laryngeal paralysis requires close attention to anesthetic plane and coordination of respiratory effort with laryngeal motion. Surgical arytenoid lateralization improves respiration and quality of life in dogs with laryngeal paralysis; however, aspiration pneumonia is a recognized complication, and generalized neuropathy can progress. Laryngeal collapse can result from any cause of chronic upper airway obstruction, but is most often associated with unaddressed brachycephalic airway syndrome. Laryngeal neoplasia, while generally uncommon, occurs more frequently in cats than in dogs.
Collapse
Affiliation(s)
- Catriona Macphail
- Department of Clinical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
| |
Collapse
|
12
|
von Pfeil DJF, Edwards MR, Déjardin LM. Less invasive unilateral arytenoid lateralization: a modified technique for treatment of idiopathic laryngeal paralysis in dogs: technique description and outcome. Vet Surg 2014; 43:704-11. [PMID: 24708449 DOI: 10.1111/j.1532-950x.2014.12151.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Accepted: 12/04/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To (1) describe a modification of conventional unilateral cricoarytenoid lateralization (UCAL), called less-invasive unilateral cricoarytenoid lateralization (LI-UCAL) for treatment of idiopathic laryngeal paralysis (LP); (2) report clinical outcome of LI-UCAL; and (3) describe the effect of early discharge after surgery. STUDY DESIGN Retrospective clinical study. ANIMALS Dogs (n = 22). METHODS Medical records (January 2009 to October 2011) of dogs diagnosed with idiopathic LP that had LI-UCAL were reviewed. Signalment, clinical signs, laboratory tests, imaging, concurrent medical conditions, information from the anesthesia record, and hospitalization time were documented. Follow-up was obtained by direct examination, questionnaire, and review of medical records from referring veterinarians. RESULTS Dogs included in the study had variable degrees and duration of respiratory distress before surgery. Median surgery time was 32 minutes. Median hospitalization was 6 hours, and median follow-up was 427 days. Long-term respiratory function, as reported by owners at last follow-up, improved in 95.5% of dogs after surgery; exercise tolerance improved by 90%. Major complications included death secondary to aspiration pneumonia (9%), aspiration pneumonia from which dogs recovered within 3 days after administration of antimicrobials (9%), and development of right-sided laryngeal collapse that required right sided LI-UCAL (4.5%). At long-term follow-up, 95.5% of owners were satisfied with the surgical outcome. CONCLUSION LI-UCAL is a feasible surgical technique and resulted in improvement of clinical signs related to LP. Calm recoveries without adverse effects such as respiratory distress were associated with early discharge. LI-UCAL could be considered an alternative to conventional UCAL.
Collapse
Affiliation(s)
- Dirsko J F von Pfeil
- Veterinary Specialists of Alaska P.C., Anchorage, AK; Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan
| | | | | |
Collapse
|
13
|
Cuddy LC, Case JB, Ellison GW, Covey JL. Video-assisted unilateral cricoarytenoid laryngoplasty in 14 dogs with bilateral idiopathic laryngeal paralysis. Vet Q 2013; 33:181-5. [PMID: 24320612 DOI: 10.1080/01652176.2013.873962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Unilateral cricoarytenoid laryngoplasty is commonly performed for treatment of idiopathic laryngeal paralysis in dogs. Determination of the appropriate tension applied to the suture can be difficult, particularly for the novice surgeon. OBJECTIVE To describe a technique for video-assisted unilateral cricoarytenoid laryngoplasty (VAUCAL) and to report short-term outcome in dogs undergoing VAUCAL. ANIMALS AND METHODS Dogs (n = 14) with bilateral idiopathic laryngeal paralysis undergoing VAUCAL between August 2011 and May 2013 were evaluated. A cricoarytenoid suture was tensioned under video observation of the rima glottidis using a 5-mm rigid endoscope. Real-time visualization of arytenoid abduction during suture tensioning, and final arytenoid position were assessed. Requirement for additional intravenous anesthestic, intra- and post-operative complications and short-term outcomes were documented. RESULTS Adequate, real-time visualization of the larynx during tensioning of the cricoarytenoid suture was accomplished in 13/14 dogs. Additional intravenous anesthesia was required in 5/14 dogs to facilitate reintubation. Final arytenoid position was considered inadequate in two dogs on post-operative trans-oral laryngeal examination. Recurrence of clinical signs occurred in one dog three months following initial surgery. Owner outcome was deemed good (n = 8) or excellent (n = 6). CONCLUSIONS VAUCAL is a feasible technique to permit direct real-time visualization of the larynx during tensioning of the cricoarytenoid suture, and enables assessment of final arytenoid position intra-operatively by the operating surgeon. CLINICAL IMPORTANCE VAUCAL allows the operating surgeon to assess arytenoid abduction intra-operatively, at the time of knot placement. This technique may be particularly useful for the novice surgeon or surgeon in training.
Collapse
Affiliation(s)
- Laura C Cuddy
- a Department of Surgery, Section of Veterinary Clinical Studies, School of Agriculture, Food Science and Veterinary Medicine , University College Dublin , Ireland
| | | | | | | |
Collapse
|
14
|
Mercurio A. Complications of Upper Airway Surgery in Companion Animals. Vet Clin North Am Small Anim Pract 2011; 41:969-80, vi-vii. [DOI: 10.1016/j.cvsm.2011.05.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|