Upper airway obstruction with inspiratory dyspnea is common in brachycephalic dogs, especially English Bulldogs.1 The most common lesion in affected dogs is elongation of the soft palate, although stenosis of the nares and hypoplasia of the trachea can also be seen.1–3 Eversion of the laryngeal saccules and laryngeal collapse can develop secondary to upper airway obstruction.1
The standard treatment for dogs with elongation of the soft palate in which secondary laryngeal disease has not yet developed is resection.2–10 Sharp excision with a scalpel or scissors followed by primary closure with apposition of the oropharyngeal and nasopharyngeal mucosa is the traditional method for removing the elongated portion of the soft palate.11,12 More recently, use of electrocautery and low-temperature, high-frequency radiosurgery units for resection of the excess tissue has been described,6,12 with suturing not required in most dogs in which a radiosurgery unit has been used for soft palate resection.12 Use of a CO2 laser for soft palate resection has also been described13; suturing was not required in most dogs, although special safety precautions were necessary. In 1 study,14 resection of the soft palate with a CO2 laser required less operative time than did the conventional incisional technique and yielded similar clinical outcomes.
An electrothermal, feedback-controlled BSD that permanently seals blood vessels up to 7 mm in diameter by means of a bipolar current adjusted on the basis of impedance to current flow through the tissue has been developed for use as an electrosurgical device during traditional open and endoscopic procedures.15,16 In a previous study17 in which histologic changes that occurred in the soft palate following resection with the BSD or a CO2 laser were compared, the depth of tissue injury did not differ between the 2 devices. Hemorrhage control was excellent with both devices, but use of the BSD for soft palate resection was faster than was use of the CO2 laser. Outcome of dogs with upper airway obstruction in which the BSD was used to resect the elongated portion of the soft palate has not been reported. The purpose of the study reported here, therefore, was to determine the efficacy of and complications associated with the use of an electrothermal, feedbackcontrolled BSD for resection of the elongated portion of the soft palate in brachycephalic dogs with upper airway obstruction.
Bipolar sealing device
LigaSure with the Precise, Xtd, and Max handpieces, Covidien Animal Health, Mansfield, Mass.
SigmaStat, version 3.0, Systat Software Inc, Point Richard, Calif.
Hedlund CS, Fossum TW. Surgery of the upper respiratory system. In: Fossum TW, ed. Small animal surgery. 2nd ed. St Louis: Mosby, 2002:716–759.
Harvey CE, Venker-van Haagen AJ. Surgical management of pharyngeal and laryngeal airway obstruction in the dog. Vet Clin North Am Small Anim Pract 1975;5:515–535.
Singleton WB. Partial velum palatectomy for the relief of dyspnea in brachycephalic breeds. J Small Anim Pract 1962;3:215–216.
Clark GN, Sinibaldi KR. Use of a carbon dioxide laser for treatment of elongated soft palate in dogs. J Am Vet Med Assoc 1994;204:1779–1781.
Davidson EB, Davis MS, Campbell GA, et al. Evaluation of carbon dioxide laser and conventional incisional techniques for resection of soft palates in brachycephalic dogs. J Am Vet Med Assoc 2001;219:776–781.
Heniford BT, Matthews BD, Sing RF, et al. Initial results with an electrothermal bipolar vessel sealer. Surg Endosc 2001;15:799–801.
Kennedy JS, Stranahan PL, Taylor KD, et al. High-burst-strength, feedback-controlled bipolar vessel sealing. Surg Endosc 1998;12:876–878.
Brdecka D, Rawlings C, Howerth E, et al. A histopathological comparison of two techniques for soft palate resection in normal dogs. J Am Anim Hosp Assoc 2007;43:39–44.
Torrez CV, Hunt GB. Results of surgical correction of abnormalities associated with brachycepalic airway obstruction syndrome in dogs in Austrailia. J Small Anim Pract 2006;47:150–154.
Riecks TW, Birchard SJ, Stephens JA. Surgical correction of brachycephalic syndrome in dogs: 62 cases (1991–2004). J Am Vet Med Assoc 2007;230:1324–1328.
Monnet E. Brachycephalic airway syndrome. In: Slatter D, ed. Textbook of small animal surgery. 3rd ed. Philadelphia: Saunders, 2003;808–813.
Pink JJ, Doyle RS, Hughes JM, et al. Laryngeal collapse in seven brachycephalic puppies. J Small Anim Pract 2006;47:131–135.
Gourley IM, Gregory CR. Soft palate resection. In: Gourley IM, Gregory CR, eds. Atlas of small animal surgery. New York: Gower, 1992;4.6–4.8.