Video-assisted unilateral cricoarytenoid laryngoplasty in 14 dogs with bilateral idiopathic laryngeal paralysis1.

摘要

Background: Unilateral cricoarytenoid laryngoplasty is commonly performed for treatment of idiopathic laryngeal paralysis in dogs. Determination of the appropriate tension applied to the suture can be difficult, particularly for the novice surgeon. Objective: To describe a technique for video-assisted unilateral cricoarytenoid laryngoplasty (VAUCAL) and to report short-term outcome in dogs undergoing VAUCAL. Animals and methods: Dogs (n=14) with bilateral idiopathic laryngeal paralysis undergoing VAUCAL between August 2011 and May 2013 were evaluated. A cricoarytenoid suture was tensioned under video observation of the rima glottidis using a 5-mm rigid endoscope. Real-time visualization of arytenoid abduction during suture tensioning, and final arytenoid position were assessed. Requirement for additional intravenous anesthestic, intra- and post-operative complications and short-term outcomes were documented. Results: Adequate, real-time visualization of the larynx during tensioning of the cricoarytenoid suture was accomplished in 13/14 dogs. Additional intravenous anesthesia was required in 5/14 dogs to facilitate reintubation. Final arytenoid position was considered inadequate in two dogs on post-operative trans-oral laryngeal examination. Recurrence of clinical signs occurred in one dog three months following initial surgery. Owner outcome was deemed good (n=8) or excellent (n=6). Conclusions: VAUCAL is a feasible technique to permit direct real-time visualization of the larynx during tensioning of the cricoarytenoid suture, and enables assessment of final arytenoid position intra-operatively by the operating surgeon. Clinical importance: VAUCAL allows the operating surgeon to assess arytenoid abduction intra-operatively, at the time of knot placement. This technique may be particularly useful for the novice surgeon or surgeon in training.