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Laryngeal Paralysis and Brachycephalic Airway Syndrome
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Laryngeal Paralysis and Brachycephalic Airway Syndrome
Final 3
Study
1
Question
What is the most common process leading to laryngeal paralysis?
Answer
Idiopathic degeneration of recurrent laryngeal nerves
2
Question
Besides degeneration, what are other causes of laryngeal paralysis?
Answer
Trauma, masses, neuropathy, polymyopathy, hypothyroidism, axonopathy
3
Question
What is stridor?
Answer
High-pitched sound from narrowed tracheal opening during inspiration
4
Question
What is the most common cause of stridor in small animals?
Answer
Laryngeal paralysis
5
Question
Why does laryngeal paralysis lead to aspiration pneumonia?
Answer
Impaired laryngeal opening/closing allows foreign material entry and increases effort
6
Question
How is heatstroke associated with laryngeal paralysis?
Answer
Altered panting impairs heat dissipation
7
Question
Why is ataxia associated with laryngeal paralysis?
Answer
Degeneration affects nerves beyond recurrent laryngeal nerves, including those controlling coordination
8
Question
How does laryngeal paralysis differ from laryngeal collapse?
Answer
Collapse involves inward sucking of the larynx with inspiration and vibrations
9
Question
What differentials should be considered for laryngeal paralysis?
Answer
Tumors, trauma, fibrosis, collapse, myasthenia gravis, endocrinopathy
10
Question
Why perform a physical and neurologic exam in suspected laryngeal paralysis?
Answer
To rule out other diseases and confirm suspicion
11
Question
Why perform cervical/thoracic radiographs or CT in suspected laryngeal paralysis?
Answer
To detect masses or abnormalities not palpable physically
12
Question
What definitively diagnoses laryngeal paralysis?
Answer
Anesthetized laryngeal examination
13
Question
What is the most common surgical treatment for laryngeal paralysis?
Answer
Cricoarytenoid lateralization ('Laryngeal Tie-Back')
14
Question
What procedures can correct laryngeal paralysis aside from tie-back?
Answer
Partial laryngectomy, permanent tracheostomy, reinnervation, Castellated laryngofissure, laser arytenoidectomy
15
Question
How is a partial laryngectomy performed and what are concerns?
Answer
Resection of displaced arytenoid; concerns include hemorrhage, discomfort, aspiration
16
Question
When is a permanent tracheostomy indicated?
Answer
Increased aspiration risk; to bypass upper airway obstruction
17
Question
What are concerns with laryngeal muscle reinnervation?
Answer
Long recovery, limited practicality
18
Question
Describe the Castellated laryngofissure procedure.
Answer
Ventral cut through thyroid cartilage, shift to abduct arytenoids, risk of hemorrhage
19
Question
How is an intraoperative laryngeal exam performed?
Answer
Support maxilla, depress tongue, assess movement, push arytenoids laterally
20
Question
Main goals when anesthetizing for a laryngeal exam?
Answer
Muscle relaxation with maintained normal laryngeal function
21
Question
Which induction drugs are used, and what are concerns?
Answer
Alfaxalone, Propofol; may reduce motion, cause apnea, respiratory depression
22
Question
Premedications beneficial during exam and their roles?
Answer
Acepromazine, Butorphanol (reduce induction needed); Dexmedetomidine (research needed); Doxapram (stimulate respiration)
23
Question
What is Doxapram and why is it used?
Answer
Respiratory stimulant; overrides depressant effects of induction agents
24
Question
Adverse effects of Doxapram?
Answer
Tachycardia, hypertension, paradoxical motion at large doses
25
Question
Can drugs like propofol affect laryngeal function?
Answer
Yes, drugs can alter laryngeal movement
26
Question
Main post-op management goals after laryngeal tie-back?
Answer
Minimize barking, prevent swimming, control drinking
27
Question
What is the general prognosis for laryngeal paralysis?
Answer
Poor, breed-dependent; variable outcomes
28
Question
How does brachycephalic airway syndrome develop?
Answer
Skull shape from breeding causes narrowed airways and increased resistance
29
Question
During which phase of inspiration is breathing more difficult in brachycephalics?
Answer
Inspiration phase
30
Question
Key signs of brachycephalic airway syndrome?
Answer
Stertor, prolonged inspiration, regurgitation, stridor, exercise intolerance, cyanosis, syncope, open-mouth breathing