Chirurgia dróg oddechowych Syndrom brachycefaliczny – wprowadzenie
Anatomic and functional changes in the airways of the brachycephalic breeds
Originally the clinical signs were thought of as being due to stenotic nares and elongated soft palate. As a consequence of the increased inspiratory efforts, the laryngeal saccules could evert (laryngoceles) and the larynx could even collapse.
Recently, new endoscopic, radiologic and computed-tomographic studies have demonstrated that the distribution of respiratory tract obstruction is more multifocal. The excessive selection for brachycephalia has led to changes and deformations of the entire upper respiratory tract. Both tissue hyperplasia and collapse of the airways are observed (Oechtering et Oechtering 2007; Grand et Bureau 2011). This new knowledge opens the path for future surgical improvements.
A mutlilevel obstruction
Nasal obstruction: nostrils, vestibule
The openings of the nostrils (nares) are bounded medially by the nasal septum and laterally by the most mobile portion of the nose, the wing of the nostril (ala nasi), which contains most of the dorsolateral and accessory nasal cartilages. Various terms have been used to refer to the ala nasi, including „alar fold” which is a misnomer as the actual alar fold is an extension of the ventral nasal concha terminating within the nasal vestibule by a bulbous enlargement that fuses to the wing of the nostril (Evans 1993).
One typical and easily recognizable feature of brachycephalic dogs is stenosis of the nares. The opening of the nose is then reduced, as seen from the exterior, to a vertical slit. Stenotic nares have been considered to be primary anatomical components of BS, and their early correction has been advocated to minimize exacerbation of obstructive disease at other sites such as soft palate and larynx (Aron and Crowe 1985; Wykes 1991; Tobias 2010).
It is filled to a large extent by the ala nasi which then merges into the plica alaris. In brachycephalic animals in relation to the nose, the ala i...
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