Laryngeal Paralysis

Question 1

What is the most common cause of larpar?

Answer 1

Idiopathic polyneuropathy
Geriatric Onset Laryngeal Paralysis Polyneuropathy
Recurrent laryngeal nerve affected first

Question 2

What is the pathophysiology behind larpar?

Answer 2

Absence of abduction of the arytenoid cartilages during inspiration

Question 3

What are the 2 different clinical presentations for dogs with larpar?

Answer 3

Acute on chronic
Chronic

Question 4

How do patients with acute on chronic larpar present?

Answer 4

Inspiratory stridor
Collapse
Upper airway obstruction
Pulmonary edema
Aspiration pneumonia
Heatstroke

Question 5

How do patients with chronic larpar present?

Answer 5

Inspiratory stridor
Exercise intolerance
Change in bark
Cough/gag
Aspiration pneumonia

Question 6

What is the diagnostic workup for larpar?

Answer 6

BW: WBC = pneumonia
Endocrine = hypothyroidism
Thoracic rads
+/- Esophagram

Question 7

What is seen on radiographs with larpar?

Answer 7

Megaesophagus
Aspiration pneumonia
Pulmonary edema
Mediastinal masses

Question 8

What is the most common surgical treatment for larpar?

Answer 8

Arytenoid lateralization - “tie back”

Question 9

What is the prognosis for laryngeal paralysis?

Answer 9

Good to excellent with arytenoid lateralization
Aspiration pneumonia increases risk of post-op complications by 2.75x

Question 10

What complications are associated with cricoarytenoid lateralization?

Answer 10

Aspiration pneumonia
Suture failure
Seroma