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Flashcards in Surgical conditions of the Airways Deck (79)
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1

rhinarium - congenital deformities

stenotic nares
cleft - harelip primary cleft palate

2

rhinarium - lacerations

haemorrhage - can heal by 2nd intention
primary closure can also be done

3

rhinarium - neoplasia

squamous cell carcinoma
wide local excision

4

nasal cavity - chronic hyperplastic rhinitis

infl in nasal cavity - stimulates hyperplasia of mucous membranes + incr mucous secretion

5

nasal cavity - chronic hyperplastic rhinitis - treatment

specific therapy for underlying predisposing factors
rhinotomy + turbinectomy

6

nasal cavity - trauma

epistaxis, deformity
usually little need for orthapaedic fixation
decr maxillary fractures
possibility of acquired palatine clefts
occasional sequestrum formation

7

nasal cavity - dental disease

mucopurulent discharge
unilateral
radiography
lesions in oral cavity

8

nasal cavity - intranasal neoplasia

most are malignant - carcinoma, adenocarcinoma, chondro, fibro, osteo - sarcoma
benign polypoid rhinitis
exploratory rhinotomy

9

nasal cavity - mycotic rhinitis - treatment

if medicine fails - place irragation tubes via sinusotomy

10

nasal cavity - foreign bodies

sudden onset sneezing, serous discharge
may progress to mucoid/purulent in chronic
rhinotomy may be needed for confirmation

11

congenital defects of the secondary palate

unable to suckle properly + nasal return of milk
aspiration pneumonia
if mild - chronic nasal discharge

12

aquired defects of the secondary palate

trauma due to tooth extraction or other
aspiration pneumonia
chronic nasal discharge + sneezing due to impaction of food into nasal cavity

13

Brachycephalic Airway Obstruction Syndrome - Primary pathology

Stenotic nares
Long soft palate

14

Brachycephalic Airway Obstruction Syndrome - secondary pathology

Eversion of the mucosa of the lateral laryngeal venricles
Laryngeal collapse
many brachycephalic dogs have tracheal hypoplasia, redundant pharyngeal mucosa + scolling of epiglottis

15

Brachycephalic Airway Obstruction Syndrome - clinical features

mild - exercise intolerance/dyspnoea when stressed
worse in heat + stress
noise on inspiration + expiration
laryngeal + pharyngeal oedema

16

Brachycephalic Airway Obstruction Syndrome - diagnosis

PE
hematology + serum chemistry
thoracic radiography
lateral radiography of larynx
pharynx + larynx exam

17

Brachycephalic Airway Obstruction Syndrome - clinical actions

Oxygen supplementation
Cool intravenous fluids
Whole body cooling
Sedation
Emergency
intubation/tracheostomy

18

Brachycephalic Airway Obstruction Syndrome - treatment

rhinoplasty
staphylectomy (removal of uvula)
resect everted mucosa of lateral laryngeal ventricles
post-op tracheostomy management

19

tracheal hypoplasia

in bulldogs - narrowed trachea.
no surgical treatment
live a normal life, providing their upper airway is in good condition
can be v.severe

20

post op care for tracheotomy

Constant monitoring.
Insert sleeve removed and cleaned every 2hrs
Nebulization every 4hrs
Limit physical activity
Suction tube only if necessary.

21

causes of laryngeal collapse

Orotracheal intubation
Emergency tracheostomy
Partial laryngectomy
Arytenoid lateralization
Permanent tracheostomy

22

laryngeal paralysis - Aetiopathogeneis

Congenital
Acquired - trauma, neoplasia, secondary to polyneuropathy/polymyopathy
Acquired (Idiopathic)

23

laryngeal paralysis - clinical features

chronic progressive exercise intolerance
dysphonia
incri respi noise (esp in inspiration stridor)
chronic cough.
cyanosis and collapse - heat stress and excitement, animals are often pyrexic.

24

laryngeal paralysis - diagnosis - obstructive crisis

hyperthermic.
Sedation
oxygen supplementation,
cool intravenous fluids
external body cooling
Occasionally, rapid anesthetic induction and orotracheal intubation
tube tracheostomy will permit complete patient evaluation prior to definitive treatment.

25

laryngeal paralysis - diagnosis - stable patient

careful physical exam
Hematology & biochemistry: concurrent/intercurrent disease)
Thoracic radiographs
careful evaluation of laryngeal function under a light plane of anaesthesia.

26

laryngeal paralysis - treatment

left arytenoid lateralisation - Suturing of the arytenoid to the thyroid (lateralisation) or cricoid
post-op care - animal at risk of aspiration pneumonia

27

laryngeal neoplasia - clinical signs

Dysphonia
Sonorous respiration,
Exercise intolerance,
Respiratory distress.

28

types of laryngeal neoplasia

congenital rhabdomyosarcoma (oncocytoma), squamous cell carcinoma adenocarcinoma, chondrosarcoma, fibrosarcoma and lymphoma

29

laryngeal paralysis - treatment outcome

Overall 85 - 90% improved long-term
Short term complication rate of 30%
All postoperative deaths involved concurrent disease
processes

30

laryngeal paralysis - treatment complications

poor arytenoid abduction
hematoma formation
laryngeal penetration
aspiration pneumonia