Day 4 - Airways Flashcards
GP tympany
Cause: Plica salphyngiea works as a one way valve. Congenital
Tx:
- Foley catheter for 2-3 wks
In case of arterial occlusion: Balloon catheter and coil embolisation
GP mycosis
Aspergillus. quite similar to GP tympany, more bleeding
Tx: Arterial occlusion: → usually int. carotid ways
– coil embolisation
– Balloon catheter occlusion
Pharynx
Developmental abnormalities:
- Palatoschisis
– Choana atresia
Pharynx
Functional abnormalities (2)
DDSP/soft palate instability > pharyngeal collapse. Dynamic
(Dorsal displacement of the soft palate)
DDSP vs iDDPS- Treatment
DDPS Conservative: Larynx position: tongue-tie, „Cornell collar“ + NSAIDS
iDDPS: Surgical
– laryngeal tie-forward
– Myectomy (M. sternothyreodieus)
– Staphylectomy ?? → Removes part of soft palate – Scarring of the soft palate with laser
Pharyngeal cysts
- Where?
– Subepiglottial
– In pharyngeal wall
– In soft palate (worst) - Removal:
– Surgical excision
– Laser
Dynamic disorders larynx (5)
- Recurrent laryngeal Hemiplegia (RLH)
- Axial deviation of the aryepiglottic fold
- Proc. Corniculatus apex collapsus
- Intermittent epiglottis entrapment
- Epiglottis retroversion
Permanent disorders of the larynx (4)
- Epiglottis Entrapment
- Arytenoid chondritis
- Subepiglottial cyst
- 4BAD
Pathogenesis- Hemiplegia laryngis (RLN)
-Idiopatic
* Progressive degeneration of dist. fibers of NLR sin.
- Genetic, large horses
Hemiplegia laryngis (RLN) - Causes, CS
Causes
* Stangles
* Guttural pouch mycosis
* Perivascular inj, Periphlebitis
* Operations
* Intoxications, (Led, organophsph.)
* Tumors (neck, thorax)
* CNS
CS: noice at insp.
Hemiplegia laryngis - Diag, Treatment
DIag:
* Palpation (CAD-atrophy)
* US of the larynx
* Endoscopy at rest and dynamic (treadmill)
– Abduction
– slap test (contralat. Adductio
– Cervicolaryngeal Reflex)
* Noise (voiceprint, spectrogram)
* Spirometry (Air capacity of lungs)
* Lobelin-stimulation
- Laryngoplasty (LP) + Ventricul(ocord)ectomy &
- Arytenoidectomy (if LP unsuccessfull)
Hemiplegia laryngis - complications
- Laryngospasmus
- Ödem, Serom (7 – 30%)
- Wound infection (0,5–6%)
- Cough (43 %, after 6M.: 14%)
- Repeated LP (10% weak; 7% too tight) * LP not holding (2-20%)
- Dysphagia (<1%)
Axial deviation of the Aryepiglottic Fold
Occ, Tx, CS
Occurrence: dynamic, bilateral (rigth?), Racing
Treatment: Transendoscopic Laser excision
Clinical signs: Poor performance, Worse with time, older horses, often chronic
- Acute:
– perichondrial oedema
– fever, lethargic, leucocytosis - Ulceration, Kissing lesion
Treatment
* Acute: AB, NSAIDs, „throat spray”. Tracheotomy – in emergency
* Chronic: Partial arytenoidectomy
Epiglottic entrapment - CS, Tx
- Primary inspiratory noise
- Poor performance in race horses
- Can be just an endoscopic finding
- Coughing after drinking water, Nasal discharge
Diode laser
Soft palate cyst
Occ, CS, Diag, Tx
Occurrence, Clinical Signs
* Young race horses
* Foals (congenital form?)
* Noise during inspiration (asphyxia), Cough
* Dysphagia, aspiration pneumonia
Diagnosis: Endoscopy, Lat-lat X-rays, Palpation
Treatment
* oral extraction
* Laryngotomy – submucosal excision (remove w/ little mucosa)
* formalin – Injeciton
* Laser
Stomatitis and glossitis - caused by? (4)
- Foreign bodies
– Barley or grass awns
– Metallic electrolyte - Phenylbutasone overdosing (ulcer)
- Vesicular stomatitis
- Actinobacillosis (A. lignieresii)
Congenital oesophagal diseases (4)
– Oesophageal duplication cysts
– Persistent right aortic arch
– Idiopathic megaoesophagus
– Congenital stenosis
Aquired oesophagal diseases (8)
– Obstruction (most common), Foreign body
– Compression, stricture
– Gastrooesophageal reflux disease
– Diverticula (congenital and acquired)
– Trauma, perforation
– Megaoesophagus
– Granulation tissue
– Neoplasia
Oesophageal obstruction
Types and places
Intraluminal, intramural, extramural
– Cervical part
– Thoracic inlet
– Base of heart
– Gastric cardia
Oesophagitis
- Often ulcerative
- Reflux oesophagitis
Tx: Control gastric acidity, delayed gastric outflow, diet
AB, sucralfat and NSAIDS
Progressive Ethmoidal Haematoma (PEH)
Submucosa-Bleeding: Ethmoid turbinate Region
Dx: Endoscopy (!), CT/MRI
Tx: Transendoscopic laser, Sinusotomy
Sinusitis - general
Primary (rare) - secondary (teeth probl.)
CS: Smelly discharge, swellings, decr airflow
Dx: Endoscopy, Xray
Primary sinusitis - Tx
Treatment of the causes swab
* Strept. equi equi (Stangles) ?!
* Trimethoprim-Sulfonamide or Similar AB for 7–14d
* Feed from the Ground
* Dust „Free” Surroundings
* Trepanation and lavage
Secondary sinusitis - Tx
Treat Primary Cause First…
* Remove Tooth
* Sinusotomy („Sinus Flap“)
Sequester / Tumor Removal Pyogen Membran Curette,…
Lavage
