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Sealing peri-cuff leak of a small endotracheal tube passing through laryngeal web in five dogs (2015–2019)

Jiyoung KimDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Hyunseok KimDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Dalhae KimDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Donghwi ShinDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Inhyung LeeDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Won-gyun SonDepartment of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea

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Abstract

CASE DESCRIPTION

5 dogs with a history of ventriculocordectomy were anesthetized with isoflurane for ovariohysterectomy, dental prophylaxis, or intracapsular lens extraction.

CLINICAL FINDINGS

No remarkable, abnormal clinical signs such as exercise intolerance, respiratory distress, or stridor were found in 4 dogs. However, 1 dog had cough after drinking, which had started after the ventriculocordectomy. During intubation, laryngeal web, suspected to be a complication of ventriculocordectomy, was accidentally discovered.

TREATMENT AND OUTCOME

Laryngeal web was observed during intubation, necessitating the use of a smaller-diameter endotracheal tube (ETT) for intubation. However, the smaller cuff volume of the smaller ETT did not prevent the air leak. Therefore, the ETT with the inflated cuff was pulled cranially until the narrowed laryngeal lumen was plugged with the cuff behind the vocal cords. The ETT was secured to prevent slippage. No air leakage around the ETT cuff or complications related to the ETT placement were observed in the peri-anesthetic period in any dog.

CLINICAL RELEVANCE

Laryngeal web can be found in patients with a history of larynx-related surgeries and may allow only a small-diameter ETT to pass through. The sealing technique used for peri-cuff air leak using a small ETT described here that can pass through a laryngeal web could be useful to seal an air leak around the cuff without complications.

Abstract

CASE DESCRIPTION

5 dogs with a history of ventriculocordectomy were anesthetized with isoflurane for ovariohysterectomy, dental prophylaxis, or intracapsular lens extraction.

CLINICAL FINDINGS

No remarkable, abnormal clinical signs such as exercise intolerance, respiratory distress, or stridor were found in 4 dogs. However, 1 dog had cough after drinking, which had started after the ventriculocordectomy. During intubation, laryngeal web, suspected to be a complication of ventriculocordectomy, was accidentally discovered.

TREATMENT AND OUTCOME

Laryngeal web was observed during intubation, necessitating the use of a smaller-diameter endotracheal tube (ETT) for intubation. However, the smaller cuff volume of the smaller ETT did not prevent the air leak. Therefore, the ETT with the inflated cuff was pulled cranially until the narrowed laryngeal lumen was plugged with the cuff behind the vocal cords. The ETT was secured to prevent slippage. No air leakage around the ETT cuff or complications related to the ETT placement were observed in the peri-anesthetic period in any dog.

CLINICAL RELEVANCE

Laryngeal web can be found in patients with a history of larynx-related surgeries and may allow only a small-diameter ETT to pass through. The sealing technique used for peri-cuff air leak using a small ETT described here that can pass through a laryngeal web could be useful to seal an air leak around the cuff without complications.

Contributor Notes

Corresponding author: Dr. Son (carpeego@snu.ac.kr)