Folded-flap palatoplasty is not superior to cut-and-sew staphylectomy for the treatment of brachycephalic obstructive airway syndrome in English Bulldogs

Janet A. Grimes Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA

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 DVM, MS, DACVS https://orcid.org/0000-0003-4554-8013
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Lisa R. Reno Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA

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Mandy L. Wallace Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA

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Brian J. Sutherland Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA

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Rachel A. Reed Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA

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Michael Perlini Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA

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Chad W. Schmiedt Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA

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Abstract

OBJECTIVE

To determine whether folded-flap palatoplasty (FFP) results in improved respiratory outcomes compared to standard staphylectomy (SS).

METHODS

English Bulldogs were randomized to receive FFP or SS in a parallel, equal-allocation, prospective study design at a single institution. Exercise-tolerance testing (ETT), arterial blood gas, head CT, and an owner survey were completed preoperatively and at recheck (approx 30 days postoperatively). Soft palate (SP) length and thickness and pharyngeal air volume were measured on blinded CT images. Linear mixed models and Mann-Whitney U tests were performed.

RESULTS

16 dogs completed the study (FFP group, 8; SS group, 8) and 3 did not (excluded due to FFP dehiscence [2] and lack of recheck [1]). Median preoperative ETT grade was not different between groups (SS group, 1 [0 to 3]; FFP group, 1.5 [1 to 3]). Standard staphylectomy resulted in a greater reduction in SP length compared to FFP (P = .020; FFP, 5.79 ± 0.50 cm preoperatively, 4.86 ± 0.52 cm at recheck; SS, 6.13 ± 0.53 cm preoperatively, 4.57 ± 0.47 cm at recheck). No other variables differed between groups. At recheck, owners subjectively rated their dogs as improved (FFP group, 5; SS group, 8), unchanged (FFP group, 2), and not rated (FFP group, 1).

CONCLUSIONS

Folded-flap palatoplasty did not improve SP thickness, pharyngeal air volume, ETT, arterial blood gas values, or owner survey variables more than SS in these English Bulldogs. Standard staphylectomy resulted in a greater reduction in SP length than FFP.

CLINICAL RELEVANCE

Standard staphylectomy or FFP can be performed in English Bulldogs. Standard staphylectomy may be preferable due to dehiscence potential with FFP.

Abstract

OBJECTIVE

To determine whether folded-flap palatoplasty (FFP) results in improved respiratory outcomes compared to standard staphylectomy (SS).

METHODS

English Bulldogs were randomized to receive FFP or SS in a parallel, equal-allocation, prospective study design at a single institution. Exercise-tolerance testing (ETT), arterial blood gas, head CT, and an owner survey were completed preoperatively and at recheck (approx 30 days postoperatively). Soft palate (SP) length and thickness and pharyngeal air volume were measured on blinded CT images. Linear mixed models and Mann-Whitney U tests were performed.

RESULTS

16 dogs completed the study (FFP group, 8; SS group, 8) and 3 did not (excluded due to FFP dehiscence [2] and lack of recheck [1]). Median preoperative ETT grade was not different between groups (SS group, 1 [0 to 3]; FFP group, 1.5 [1 to 3]). Standard staphylectomy resulted in a greater reduction in SP length compared to FFP (P = .020; FFP, 5.79 ± 0.50 cm preoperatively, 4.86 ± 0.52 cm at recheck; SS, 6.13 ± 0.53 cm preoperatively, 4.57 ± 0.47 cm at recheck). No other variables differed between groups. At recheck, owners subjectively rated their dogs as improved (FFP group, 5; SS group, 8), unchanged (FFP group, 2), and not rated (FFP group, 1).

CONCLUSIONS

Folded-flap palatoplasty did not improve SP thickness, pharyngeal air volume, ETT, arterial blood gas values, or owner survey variables more than SS in these English Bulldogs. Standard staphylectomy resulted in a greater reduction in SP length than FFP.

CLINICAL RELEVANCE

Standard staphylectomy or FFP can be performed in English Bulldogs. Standard staphylectomy may be preferable due to dehiscence potential with FFP.

Supplementary Materials

    • Supplementary Material S1 (PDF 38 KB)
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