Fluoroscopic evaluation of laryngopharyngeal anatomic variations attributable to head posture in dogs

Yeunjeong Ha Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, South Korea.

Search for other papers by Yeunjeong Ha in
Current site
Google Scholar
PubMed
Close
 DVM
,
Jaehwan Kim Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, South Korea.

Search for other papers by Jaehwan Kim in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
,
Kyungyeon Chung Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, South Korea.

Search for other papers by Kyungyeon Chung in
Current site
Google Scholar
PubMed
Close
 DVM
,
Hakyoung Yoon Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, South Korea.

Search for other papers by Hakyoung Yoon in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
, and
Kidong Eom Department of Veterinary Medical Imaging, College of Veterinary Medicine, Konkuk University, Seoul 05029, South Korea.

Search for other papers by Kidong Eom in
Current site
Google Scholar
PubMed
Close
 DVM, PhD

Abstract

OBJECTIVE

To fluoroscopically evaluate the effects of head posture and sedation on the laryngopharyngeal anatomic structures in dogs.

ANIMALS

6 clinically normal Beagles (mean age, 6.2 years; mean weight, 10.4 kg).

PROCEDURES

Each dog was sedated and placed in right lateral recumbency, and fluoroscopic examinations were performed with flexed, neutral, and extended head postures (FHP, NHP, and EHP, respectively). During 3 respiratory cycles, the angle between the basisphenoid bone and nasopharyngeal dorsal border (ABN), thickness of the soft palate, diameter of the nasopharyngeal lumen (DNL), overlapping length between the epiglottis and soft palate, and distance between the epiglottis and tympanic bulla (DET) were measured and percentage difference in the DNL (PDNLD) during a respiratory cycle was calculated.

RESULTS

For the FHP, NHP, and EHP, median ABN was 91.50° (interquartile range [IQR], 86.75° to 95.00°), 125.00° (IQR, 124.50° to 125.50°), and 160.00° (IQR, 160.00° to 163.50°), respectively, with no significant differences between ABN and posture angle. For the FHP, median DNL and DET significantly decreased, compared with values for the NHP, and median thickness of the soft palette significantly increased. For the EHP, the minimal DNL and DET significantly increased, and the median overlapping length between the epiglottis and soft palate significantly decreased, compared with values for the NHP. The PDNLD significantly increased and decreased with FHP and EHP, respectively, compared with the PDNLD with NHP. Sedation did not affect upper airway structure changes.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that head posture significantly affected the laryngopharyngeal structures in dogs. Fluoroscopic examination of the upper respiratory tract of a dog should be performed with an NHP to minimize posture-induced changes in measurements.

Abstract

OBJECTIVE

To fluoroscopically evaluate the effects of head posture and sedation on the laryngopharyngeal anatomic structures in dogs.

ANIMALS

6 clinically normal Beagles (mean age, 6.2 years; mean weight, 10.4 kg).

PROCEDURES

Each dog was sedated and placed in right lateral recumbency, and fluoroscopic examinations were performed with flexed, neutral, and extended head postures (FHP, NHP, and EHP, respectively). During 3 respiratory cycles, the angle between the basisphenoid bone and nasopharyngeal dorsal border (ABN), thickness of the soft palate, diameter of the nasopharyngeal lumen (DNL), overlapping length between the epiglottis and soft palate, and distance between the epiglottis and tympanic bulla (DET) were measured and percentage difference in the DNL (PDNLD) during a respiratory cycle was calculated.

RESULTS

For the FHP, NHP, and EHP, median ABN was 91.50° (interquartile range [IQR], 86.75° to 95.00°), 125.00° (IQR, 124.50° to 125.50°), and 160.00° (IQR, 160.00° to 163.50°), respectively, with no significant differences between ABN and posture angle. For the FHP, median DNL and DET significantly decreased, compared with values for the NHP, and median thickness of the soft palette significantly increased. For the EHP, the minimal DNL and DET significantly increased, and the median overlapping length between the epiglottis and soft palate significantly decreased, compared with values for the NHP. The PDNLD significantly increased and decreased with FHP and EHP, respectively, compared with the PDNLD with NHP. Sedation did not affect upper airway structure changes.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that head posture significantly affected the laryngopharyngeal structures in dogs. Fluoroscopic examination of the upper respiratory tract of a dog should be performed with an NHP to minimize posture-induced changes in measurements.

Contributor Notes

Address correspondence to Dr. Eom (eomkd@konkuk.ac.kr).

Drs. Ha and Kim contributed equally to this study.

  • 1.

    Gaskell CJ. The radiographic anatomy of the pharynx and larynx of the dog. J Small Anim Pract 1974;15:89 100.

  • 2.

    Aron DN, Crowe DT. Upper airway obstruction: general principles and selected conditions in the dog and cat. Vet Clin North Am Small Anim Pract 1985;15:891 917.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Dempsey JA, Veasey SC, Morgan BJ, et al. Pathophysiology of sleep apnea. Physiol Rev 2010;90:47 112.

  • 4.

    Walsh JH, Maddison KJ, Platt PR, et al. Influence of head extension, flexion, and rotation on collapsibility of the passive upper airway. Sleep 2008;31:1440 1447.

    • Search Google Scholar
    • Export Citation
  • 5.

    Rubin JA, Holt DE, Reetz JA, et al. Signalment, clinical presentation, concurrent diseases, and diagnostic findings in 28 dogs with dynamic pharyngeal collapse (2008–2013). J Vet Intern Med 2015;29:815 821.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Griffon DJ, Tasker S. Use of a mucosal advancement flap for the treatment of nasopharyngeal stenosis in a cat. J Small Anim Pract 2000;41:71 73.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Meola SD, Stacy D. Brachycephalic airway syndrome. Top Companion Anim Med 2013;28:91 96.

  • 8.

    Pollard RE, Johnson LR, Marks SL. The prevalence of dynamic pharyngeal collapse is high in brachycephalic dogs undergoing videofluoroscopy. Vet Radiol Ultrasound 2018;59:529 534.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Alexander K. Canine and feline larynx and trachea. In: Thrall DE, ed. Textbook of veterinary diagnostic radiology. 7th ed. St Louis: Elsevier Saunders, 2018;583 595.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Gold AR, Schwartz AR. The pharyngeal critical pressure: the whys and hows of using nasal continuous positive airway pressure diagnostically. Chest 1996;110:1077 1088.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Odeh M, Schnall R, Gavriely N, et al. Dependency of upper airway patency on head position: the effect of muscle contraction. Respir Physiol 1995;100:239 244.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Anegawa E, Tsuyama H, Kusukawa J. Lateral cephalometric analysis of the pharyngeal airway space affected by head posture. Int J Oral Maxillofac Surg 2008;37:805 809.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Cehak A, Rohn K, Barton A, et al. Effect of head and neck position on pharyngeal diameter in horses. Vet Radiol Ultrasound 2010;51:491 497.

  • 14.

    Thrall DE. Basic principles of radiographic interpretation of the axial skeleton. In: Thrall DE, ed. Textbook of veterinary diagnostic radiology. 7th ed. St Louis: Elsevier Saunders, 2018;137 138.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. (Erratum published in J Chiropr Med 2017;16:346). J Chiropr Med 2016;15:155 163.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Kairaitis K, Parikh R, Stavrinou R, et al. Upper airway extraluminal tissue pressure fluctuations during breathing in rabbits. J Appl Physiol 2003;95:1560 1566.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Kairaitis K, Byth K, Parikh R, et al. Tracheal traction effects on upper airway patency in rabbits: the role of tissue pressure. Sleep 2007;30:179 186.

  • 18.

    Sonnesen L, Petersson A, Berg S, et al. Pharyngeal airway dimensions and head posture in obstructive sleep apnea patients with and without morphological deviations in the upper cervical spine. J Oral Maxillofac Res 2017;8:e4.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Hendricks JC, Kline LR, Kovalski RJ, et al. The English Bulldog: a natural model of sleep-disordered breathing. J Appl Physiol 1987;63:1344 1350.

  • 20.

    Rodríguez-Lozano FJ, Sáez-Yuguero-Mdel R, Linares-Tovar E, et al. Sleep apnea and mandibular advancement device. Revision of the literature. Med Oral Patol Oral Cir Bucal 2008;13:E549 E554.

    • Search Google Scholar
    • Export Citation
  • 21.

    Koch DA, Arnold S, Hubler M, et al. Brachycephalic syndrome in dogs. Compend Contin Educ Pract Vet 2003;25:48 55.

  • 22.

    Sinclair MD. A review of the physiological effects of α2-agonists related to the clinical use of medetomidine in small animal practice. Can Vet J 2003;44:885 897.

    • Search Google Scholar
    • Export Citation
  • 23.

    Shelton KE, Woodson H, Gay S, et al. Pharyngeal fat in obstructive sleep apnea. Am Rev Respir Dis 1993;148:462 466.

  • 24.

    Brennick MJ, Pack AI, Ko K, et al. Altered upper airway and soft tissue structures in the New Zealand obese mouse. Am J Respir Crit Care Med 2009;179:158 169.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Love L, Cline MG. Perioperative physiology and pharmacology in the obese small animal patient. Vet Anaesth Analg 2015;42:119 132.

  • 26.

    Manens J, Bolognin M, Bernaerts F, et al. Effects of obesity on lung function and airway reactivity in healthy dogs. Vet J 2012;193:217 221.

  • 27.

    Lodato DL, Hedlund CS. Brachycephalic airway syndrome: pathophysiology and diagnosis. Compend Contin Educ Pract Vet 2012;34:E3.

  • 28.

    Gaddam R, Shashikumar HC, Lokesh NK, et al. Assessment of image distortion from head rotation in lateral cephalometry. J Int Oral Health 2015;7:35 40.

    • Search Google Scholar
    • Export Citation

Advertisement