Syndrom brachycefaliczny. Rozpoznanie, etiologia, interwencje chirurgiczne

Treatment

When and what to operate

According to the pathophysiology of the syndrome, an early relief of the proximally located obstruction should be attempted because it is postulated that this early correction could prevent or even reverse ventricular eversion or laryngeal collapse. The influence of the upper airway surgical treatment on gastro-intestinal signs improvement has also been studied. After the surgical treatment of the upper airways and despite the discontinuation of a medical treatment in more than 80% of the cases, a clear improvement of the upper gastro-intestinal tract disease was observed. In the cases where the results of a control gastro-esophageal endoscopy could be obtained 6 months after upper airway surgery, they always reflected a complete resolution of the gastro-esophageal endoscopic and histopathologic symptoms. These findings support the previous hypothesis of a common pathophysiologic pathway of upper respiratory and upper gatro-esophageal disease in brachycephalic dogs.

Surgical treatment

Rhinoplasty. Several techniques of rhinoplasty have been developed. They all aim at opening the lateral wings of the nostrils. Removing this part actually increases the nostrils diameter and contributes to the improvement of the nasal flow. However a new vestibuloplasty technique is under investigation and seems to alleviate the obstruction more distally. 

Soft palate surgery. The current techniques of the treatment of the elongated soft palate involve a resection of the elongated part. In order to shorten the soft palate without inducing too much post-operative inflammation many alternatives have been developed such as staphylectomy with laser or Feed-back control devices. A new technique, „The folded flap palatoplasty”, has been proposed in order to address both pharyngeal and laryngeal obstruction. This technique causes a marked reduction of the soft palate thickness, thereby relieving the nasopharynx and oropharynx from o...

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