Evaluation of a modified castellated laryngofissure for alleviation of upper airway obstruction in dogs with laryngeal paralysis

A modified castellated laryngofissure procedure (castellated laryngofissure, vocal fold resection, and bilateral arytenoid lateralization) was performed on 12 dogs with bilateral laryngeal paralysis. Clinical signs of airway obstruction were assessed and a pulmonary function test (tidal breathing flow volume loop) was used to evaluate the severity of obstruction. The dogs were evaluated before surgery and at various periods from 4 days to 15 months after surgery. One dog died immediately after surgery and 3 dogs died due to nonrelated or unknown causes 1, 9, and 11 months after surgery. Clinical signs of upper airway obstruction disappeared or decreased in severity in the 11 dogs that recovered from surgery. Tidal breathing flow volume loop values were normal in 7 of 10 dogs evaluated within 5 to 189 days after surgery. The modified castellated laryngofissure procedure provided successful long-term relief of upper airway obstruction associated with bilateral laryngeal paralysis.     

Chronic upper airway obstruction caused by laryngeal adenocarcinoma in a cat

An eight-year-old spayed female cat developed upper respiratory obstruction, abnormal vocalisation and anorexia over a period of a few months. Examination under general anaesthesia revealed unilateral laryngeal distortion by a soft tissue mass; there was no radiographic evidence of metastatic disease at this time. Over the next four months the upper respiratory obstruction became more severe as a result of progressive laryngeal stenosis and metastatic lung masses were observed radiographically four months after initial examination. Necropsy revealed an infiltrating laryngeal adenocarcinoma with metastases in the upper cervical lymph node and lungs. This case illustrates the value of early biopsy diagnosis to spare the patient the distress of progressive upper respiratory obstruction.     

Bilateral recurrent laryngeal neurectomy as a model for the study of idiopathic canine laryngeal paralysis.

The purposes of this study were to develop an experimental model of canine laryngeal paralysis that mimicked the naturally occurring disease and to document the upper airway changes produced, both clinically and with pulmonary function testing. Ten dogs had bilateral recurrent laryngeal neurectomy performed and were recovered from anesthesia. Tidal breathing flow-volume loop analysis and upper airway resistance measurements were taken before and after the development of clinical laryngeal paralysis while dogs breathed room air and after the individual administration of 2 respiratory stimulants. Clinical signs of laryngeal paralysis developed 38 days (median) following denervation. Although some variations were present, tidal breathing flow-volume loop analyses on room air, following denervation, were similar to those reported in naturally occurring cases. Upper airway resistance increased following denervation and was significantly increased with both respiratory stimulants. We concluded that bilateral recurrent laryngeal neurectomy resulted in clinical signs and respiratory changes similar to those of idiopathic canine laryngeal paralysis.     

Upper airway obstruction in performance horses. Differential diagnoses and treatment

Abnormalities of the nasal cavity, pharynx, larynx, and trachea result in respiratory noise and exercise intolerance. Clinical features of common upper respiratory conditions of performance horses are reviewed with emphasis on diagnosis, treatment, and risk factors that affect the outcome of surgical treatment.     

Surgical management of laryngeal collapse associated with brachycephalic airway obstruction syndrome in dogs

Objective: To describe the use of cricoarytenoid lateralisation combined with thyroarytenoid caudo- lateralisation (arytenoid laryngoplasty) for the management of stage II and III laryngeal collapse in dogs. Methods: A retrospective study of a consecutive series of 12 dogs suffering from life-threatening stage II or III laryngeal collapse associated with brachycephalic airway obstruction syndrome. Results: Pre-operatively, either stage II collapse (2/12) or stage III collapse (10/12) was confirmed on visual examination. In all cases, a left-sided arytenoid laryngoplasty was performed. Two dogs were euthanased postoperatively as a result of persistent life-threatening respiratory compromise. The procedure resulted in subjective enlargement of the rima glottidis and an associated improvement in respiratory function in the remaining 10 dogs. Follow-up, long-term outcome (median, 3·5 years) in these dogs indicated that all owners considered that the surgery had resulted in marked improvements in their dog's respiratory function, tolerance to exercise, and quality of life. Clinical Significance: Combined cricoarytenoid and thyroarytenoid caudo-lateralisation may be a useful procedure for treatment of stage II and III laryngeal collapse in the dog.     

Upper airway obstruction caused by a nasopharyngeal polyp and brachycephalic airway syndrome in a Chinese Shar-Pei puppy

Objective: To describe the case management for a dog diagnosed with a nasopharyngeal polyp.
Case summary: A 9-week-old Shar-Pei puppy presented for progressive dyspnea and collapse. Clinical signs were consistent with an upper airway obstruction (UAO) and a temporary tracheostomy was performed. The puppy was at first diagnosed with and treated for brachycephalic airway syndrome but continued to exhibit signs of an UAO after soft palate resection. Nasopharyngoscopy revealed a nasopharyngeal polyp causing the UAO, which was surgically removed. The puppy has been free of clinical signs for 1 year after removal of the polyp.
New or unique information provided: This is the first report of a nasopharyngeal polyp causing a life-threatening UAO in a puppy. It emphasizes the importance of examining the nasopharyngeal space in neonates presenting with UAO.     

Use of continuous positive airway pressure in the acute management of laryngeal paralysis in a cat

Continuous positive airway pressure (CPAP) has been is used widely in humans to manage obstructive sleep apnoea syndrome, but it has not been widely used in animals. A brachycephalic cat, with previously undiagnosed laryngeal paralysis, that developed acute upper respiratory tract obstruction on recovery from anaesthesia, is presented. The condition was managed by CPAP, delivered via a facial mask.     

Neurological laryngeal paralysis in the dog

Abstract

Extract

It is always satisfying to attempt to explain the clinical signs of a disease from the altered physiology that occurs. In the article Neurogenic laryngeal paralysis in the dog(1 Burbidge, H, Goulden, BE and Jones, BR. 1991. Neurogenic laryngeal paralysis in the dog. New Zealand Veterinary Journal, 39: 83–87. [Taylor &; Francis Online], [Web of Science ®] , [Google Scholar]) the clinical signs of laryngeal stridor, increased respiratory rate and exercise intolerance could be explained as follows:     

Neurogenic laryngeal paralysis in the dog

Idiopathic laryngeal paralysis in dogs is now a frequently recognised disorder, particularly in certain breeds such as the Labrador retriever, Afghan hound and Irish setter. Since it occurs in the older animal, distinguishing the clinical signs and their significance from lower respiratory tract or cardiac disease can be challenging. At present little is known about its aetiology and therefore the treatment is directed at relieving the clinical signs. Recent work indicates that arytenoid cartilage lateralisation achieves the best results as a method of surgically correcting the laryngeal obstruction. However, it should be remembered that the potential benefits of surgery should be assessed for each individual, taking into account the presence of concurrent disease and lifestyle of the dog.     

Unilateral laryngeal paralysis in a cat

A case of unilateral laryngeal paralysis in a cat is described which presented with signs of nasal discharge and dyspnoea. The condition is compared with laryngeal paralysis as seen in the horse and dog.     

Bilateral laryngeal paralysis in the horse

Four two-year-old Thoroughbreds suffered an acute gastrointestinal illness shortly after dosing with mineral oil which was thought to have been contaminated with an organophosphate compound. Three weeks later all four were noted to be dyspnoeic and endoscopic examination showed that they had developed bilateral laryngeal paralysis. Two of the horses died during severe bouts of dyspnoea six and eight months later and the third was killed shortly thereafter. Examination of the left and right recurrent laryngeal nerves from these horses showed a severe loss of myelinated fibres distally, especially in the left nerve. A similar but less severe lesion was seen in other long peripheral nerves, including the phrenic and digital nerves of the third horse. The spinal cord in two horses showed evidence of mild axonal degeneration which was not related to a particular tract or location. The fourth horse had bilateral laryngeal paralysis two years later. The acute clinical signs and delayed neurological sequelae seen in these horses were strongly suggestive of accidental organophosphate toxicity.     

Upper airway obstruction. General principles and selected conditions in the dog and cat

This article presents an overview of the clinical features of upper airway obstructive disorders. It includes more detailed discussions of certain common conditions such as brachycephalic airway syndrome, laryngeal paralysis, and upper airway obstruction due to trauma, foreign bodies, extraluminal masses, and tumours of the larynx and trachea.     

Trypanosomiasis and laryngeal paralysis in a dog

Laryngeal paralysis and trypanosomiasis were diagnosed in a 12-year-old Labrador Retriever. Bilateral vocal fold resection and partial excision of the left aryepiglottic fold resolved the dog's respiratory difficulty. Trypomastigotes resembling Trypanosoma cruzi were seen in blood smears during hospitalization. In spite of treatment with nifurtimox and dexamethasone, the dog died. Histologic examination of tissues did not reveal amastigotes of T cruzi or granulomatous myositis previously described in canine trypanosomiasis reported from North America. The lack of granulomatous myositis and amastigotes in muscle is unusual and suggests a strain variation in the behavior of T cruzi.     

Bilateral laryngeal paralysis in a dog secondary to laryngeal osseous metaplasia

A 7-year-old spayed female Lurcher was evaluated for a chronic history of increased upper respiratory noise. Advanced imaging including digital radiography and pre- and post-contrast computed tomography (CT) scan confirmed the presence of an ill-defined soft tissue mineralized mass of the ventral larynx. Histopathology demonstrated pleocellular myositis and fasciitis with osseous metaplasia.