Laryngeal & Pharyngeal Dz - Corrigan Flashcards
(24 cards)
What are some key characteristics of Laryngeal Dz?
- Respiratory distress → increased inspiratory effort
- Stridor
- + change in vocalization
- Often acute presentation
- + Aspiration pneumonia
When an animal initially presents in respiratory distress, what is a good drug to give them to help reduce stress?
A small amt of Ace, followed by O2
C/S associated with Pharyngeal Dz?
- Stertor
- Reverse sneezing
- Gagging
- Airway obstruction → later in the dz. process
Give some examples of Laryngeal Dz’s in SAs.
- Laryngeal paralysis
- Laryngeal neoplasia
- Obstructive laryngitits
- Laryngeal collapse
- Web formation
- Trauma
- FB
- Extraluminal mass
- Acute laryngitis
Give examples of key Pharyngeal dz’s affecting SA’s.
- Brachycephalic Airway Syndrome
- Enlongated Soft Palate
- Nasopharyngeal Polyp
- Lymphoma in Cats
List the DI imaging modalities useful when diagnosing Laryngeal & Pharyngeal dz.
-
Rads
- Lateral views → larynx, caudal nasopharynx, cranial trachea
-
U/S
- Motion
- Mass aspiration
-
CT/MRI
- Masses
- Local invasion
How should you perform Laryngoscopy/Pharyngoscopy?
- Anesthesia → carefully tritrate Propofol to effect
- Have an ET tube handy
- Doxapram on hand
- makes them breath faster, helps evaluate dynamic fxn.
What anatomical structure is blocking airflow during Laryngeal Paralysis?
Arytenoid cartilages
3 things that can cause Ventral Cervical Laryngeal Paralysis?
- Nerve damage
- Neoplasia
- Inflammatory lesions
3 things that can cause Anterior Thoracic Laryngeal Paralysis?
- Neoplasia
- Trauma
- Inflammatory lesions
5 things that cause Polyneuropathy/Polymyopathy Laryngeal Paralysis?
- Idiopathic
- Immune mediated
- Hypothyroidism
- Toxicities
- Congenitial dz
Which dog breeds did Corrigan say gets Congenital Polyneuropathy Laryngeal Paralysis?
Yorkie
Bouvier des flandres (Daisy)
Management for Laryngeal Paralysis?
- Glucocorticoids → short & tapering
- Rest
- Anxiolytics
What is the success rate of SX correction of Laryngeal Paralysis?
What must the owner be made aware of before you go to SX?
- 90% >1 yr.
- MST >5 yrs.
- Patient will no longer bark, can no longer swim, can’t hang their heads out the window, etc.
Complications of Laryngeal Tieback SX?
- 14% perioperative mortality
- Aspiration pneumonia is common
- Polyneuropathy/myophaties will still progress (short term soln for these guys)
Characteristics of Brachycephalic Airway Syndrome?
- Stenoic nares
- Elongated soft palate
- Everted laryngeal saccules
- + hyoplastic trachea
- + end-stage laryngeal collapse
A bulldog w/ BAS comes in on ER b/c it can’t breath.
What can you do to help immediately?
- Anxiolytics
- Glucocorticoids
- O2
This Frenchie needs a __________.
A Rhinoplasty!
You see this on a laryngoscopy of a Pug.
What do you suspect?
Brachycephalic Airway Syndrome
What is the salvage procedure done for BAS?
Tracheostomy
A 10 yr old M/N Beagle comes into your clinic b/c his bark has changed and he has a small freely moving swelling on his ventral neck. You do a CT & see this.
What do you want do to now?
Why?
- SX →suspect Thyroid carcinoma
- Thyroid carcinomas are often highly invasive → lots of important structures are in this area that don’t need to be smushed.
What steps are you going to take for TX of Laryngeal Neoplasia?
- Abdominal & Thoracic Rads → looking for mestastis
- + SX excision
- + Radiation therapy
- + Chemo
- + Immunotherapy (vax available for Melanoma)
You find this mass while performing an oral exam on a 9 yr. old GSD.
Top 3 rule outs?
GO!
- Malignant melanoma
- SCC
- Fibrosarcoma
You are performing an oral exam on a cat and see this lesion.
Top 2 Rule outs?
GO!
- SCC
- Fibrosarcoma
