What is the purpose of inserting silicon tubes that protrude from the nares when performing nasal surgery?
To maintain the airway/To keep the airways open
What condition is nasal planum resection most commonly associated with?
Accurate apposition of nasal _____ and ____ reduces the risk of post- nasal planum resection stenosis in dogs,
T/F: The first line treatment for nasal fibrosarcoma is chemo and radiation, if that does not work surgery should be considered.
False, resection is the primary method of treatment since FSA do not respond well to chemo or radiation.
What is the best modality to assess oropharyngeal and nasal pathology, such as polyps?
__________ sutures work well in cats to decrease the size of the wound, allowing the remaining defect from a nasal planum resection to heal by second intention.
What anatomic structure must you take care to avoid when performing a blind nasal biopsy?
Cribiform plate (no touchies)
Which arteries do you risk damaging when performing nasal surgery?
Dorsal, lateral and major palatine arteries
What are some primary components of brachycephalic airway syndrome
Elongated soft palate (most common)
Stenotic nares (also common)
Shortened, flattened nasal cavity (nasopharyngeal turbinates)
What inspiratory noise is associated with an elongated soft palate?
T/F: Placement of a stent is the primary treatment for hypoplastic trachea.
False, there is no treatment.
Which drugs should you avoid when performing an upper airway exam, because they affect laryngeal function? What is usually used?
Large doses of pure mu agonists
Use: Propofol +/- Bup or Torb, Doxapram if they get too deep
What surgery is necessary for stage 1 tracheal collapse? Stage 2? Stage 3?
1: Excision of everted laryngeal saccules
2: Above + vocal fold excision and partial arytenoidectomy
3: Permanent tracheostomy
At the beginning of an upper airway examination you notice small pear-shaped masses just in front of the vocal folds. What are these?
Everted laryngeal saccules
What landmarks are used to determine the level of excision when resecting a soft palate?
The caudal border of the soft palate (should slightly cover the tip of the epiglottis on the midline)
Caudoventral border of the tonsillar crypt
Why are wet sponges used around structures that area not meant to be cut by a CO2 laser?
To protect them by absorbing the laser beam
T/F: Nasal stenosis is more common in cats than dogs post-op.
T/F: Rhinoscopy and nasophyngoscopy should be performed after imaging.
Progressively worsening inspiratory dyspnea which is exacerbated by exercise is the most common clinical sign for _____.
When performing nasal surgery, a ______ approach gives you access to the nasal cavity and sinuses, while a _____ approach gives you access to the choanae.
Ventral (also gives access to ventral nasal cavity)
Which technique is the easiest but also most traumatic for soft palate resection? Broadly, what type of suture and what suturing pattern would you use?
Fine absorbable monofilament suture (e.g. 4.0-6.0 Monocryl or Biosyn)
Continuous pattern, from edge to midpoint on each side
(Also, remember you (clamp,) cut, and suture one side and then (clamp,) cut, and suture the other side)
T/F: Tracheal collapse and everted laryngeal saccules are secondary or acquired components of brachycephalic airway syndrome.
If a laser is not available, what technique for resecting a soft palate is recommended?
Free-hand "cut and sew"
What complications accompany an overshortening the palate in a palatectomy?
T/F: An upper airway exam should be performed under deep anesthesia to prevent swallowing.
What technique for a palatoplasty would you use if you wish to both shorten and thin the palate?
What are acute complications following a palatectomy?
What do you do if you discover that while performing a palatectomy you undershortened the palate?
Redo the surgery
What diagnostics, aside from an upper airway exam, are warranted when working up a case of BAS?
Blood work (especially if in distress)
+/-: Lateral cervical rads, abdominal rads/US
What therapies are commonly administered pre-op to soft palate resections and everted saccule excision?
Dexamethasone/ corticosteroids (ALWAYS)
GI protectants and promotility agents