短头犬矫正上呼吸道手术前后鼻咽塌陷的严重程度。

Veterinary surgery : VS Pub Date : 2022-08-01 Epub Date: 2022-06-22 DOI:10.1111/vsu.13841
Dana L Clarke, Jennifer A Reetz, Kenneth J Drobatz, David E Holt
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引用次数: 0

摘要

目的:探讨短头犬矫正气道手术前后鼻咽塌陷的严重程度。动物:23只短头犬(21只有上呼吸道临床症状)和9只临床正常的非短头犬(对照)。方法:采用清醒、站立、头部处于中立位的透视法对犬进行评价。鼻咽部塌缩的幅度以呼吸过程中鼻咽部背腹侧尺寸的最大减少量来测量,并以百分比表示。对短头犬进行麻醉,评估气道,并进行矫正上呼吸道手术(鼻翼成形术、葡萄球菌切除术、小囊切除术、扁桃体切除术)。一组(n = 11)手术治疗的短头犬在手术后至少6周重复进行透视检查。结果:短头犬鼻咽部背腹侧尺寸术前中位缩小幅度更大(65%;范围:8-100%)比对照组(10%;范围:1-24%,p = 0.0001)。手术并没有改善短头犬(n = 11)术后呼吸时鼻咽背腹侧直径的减小(p = 0.0505)。结论及临床意义:鼻咽塌陷是犬短头性气道阻塞综合征的常见且有时严重的组成部分。缺乏明显的术后改善可能代表II型错误,未能充分解决增加气流阻力的解剖异常,或者在一些短头犬中上呼吸道扩张肌功能不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs.

Objective: To determine the severity of nasopharyngeal collapse in brachycephalic dogs before and after corrective airway surgery.

Animals: Twenty-three brachycephalic dogs (21 with clinical signs referrable to the upper airway) and nine clinically normal nonbrachycephalic dogs (controls).

Methods: Dogs were evaluated with fluoroscopy awake and standing with the head in a neutral position. The magnitude of nasopharyngeal collapse was measured as the maximum reduction in the dorsoventral dimension of the nasopharynx during respiration and expressed as a percentage. Brachycephalic dogs were anesthetized, the airway evaluated, and corrective upper airway surgery (alaplasty, staphylectomy, sacculectomy, tonsillectomy) was performed. A cohort (n = 11) of the surgically treated brachycephalic dogs had fluoroscopy repeated a minimum of 6 weeks after surgery.

Results: Median preoperative reduction in the dorsoventral dimensions of the nasopharynx was greater in brachycephalic dogs (65%; range: 8-100%) than in controls (10%; range: 1-24%, p = .0001). Surgery did not improve the reduction in dorsoventral diameter of the nasopharynx during respiration in brachycephalic dogs (n = 11) postoperatively (p = .0505).

Conclusion and clinical significance: Nasopharyngeal collapse was a common and sometimes severe component of brachycephalic airway obstruction syndrome in the cohort of dogs evaluated. The lack of significant postoperative improvement may represent a type II error, a failure to adequately address anatomical abnormalities that increase resistance to airflow, or inadequate upper airway dilator muscle function in some brachycephalic dogs.

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