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微创单侧杓状软骨外移术:一种治疗犬特发性喉麻痹的改良技术:技术描述与结果

Less invasive unilateral arytenoid lateralization: a modified technique for treatment of idiopathic laryngeal paralysis in dogs: technique description and outcome.

作者信息

von Pfeil Dirsko J F, Edwards Michael R, Déjardin Loïc M

机构信息

Veterinary Specialists of Alaska P.C., Anchorage, AK; Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, Michigan.

出版信息

Vet Surg. 2014 Aug;43(6):704-11. doi: 10.1111/j.1532-950X.2014.12151.x. Epub 2014 Apr 7.

Abstract

OBJECTIVE

To (1) describe a modification of conventional unilateral cricoarytenoid lateralization (UCAL), called less-invasive unilateral cricoarytenoid lateralization (LI-UCAL) for treatment of idiopathic laryngeal paralysis (LP); (2) report clinical outcome of LI-UCAL; and (3) describe the effect of early discharge after surgery.

STUDY DESIGN

Retrospective clinical study.

ANIMALS

Dogs (n = 22).

METHODS

Medical records (January 2009 to October 2011) of dogs diagnosed with idiopathic LP that had LI-UCAL were reviewed. Signalment, clinical signs, laboratory tests, imaging, concurrent medical conditions, information from the anesthesia record, and hospitalization time were documented. Follow-up was obtained by direct examination, questionnaire, and review of medical records from referring veterinarians.

RESULTS

Dogs included in the study had variable degrees and duration of respiratory distress before surgery. Median surgery time was 32 minutes. Median hospitalization was 6 hours, and median follow-up was 427 days. Long-term respiratory function, as reported by owners at last follow-up, improved in 95.5% of dogs after surgery; exercise tolerance improved by 90%. Major complications included death secondary to aspiration pneumonia (9%), aspiration pneumonia from which dogs recovered within 3 days after administration of antimicrobials (9%), and development of right-sided laryngeal collapse that required right sided LI-UCAL (4.5%). At long-term follow-up, 95.5% of owners were satisfied with the surgical outcome.

CONCLUSION

LI-UCAL is a feasible surgical technique and resulted in improvement of clinical signs related to LP. Calm recoveries without adverse effects such as respiratory distress were associated with early discharge. LI-UCAL could be considered an alternative to conventional UCAL.

摘要

目的

(1)描述一种传统单侧环杓侧方固定术(UCAL)的改良术式,即微创单侧环杓侧方固定术(LI-UCAL),用于治疗特发性喉麻痹(LP);(2)报告LI-UCAL的临床疗效;(3)描述术后早期出院的效果。

研究设计

回顾性临床研究。

动物

犬(n = 22)。

方法

回顾2009年1月至2011年10月诊断为特发性LP并接受LI-UCAL治疗的犬的病历。记录品种、临床症状、实验室检查、影像学检查、并存疾病、麻醉记录信息及住院时间。通过直接检查、问卷调查及查阅转诊兽医的病历进行随访。

结果

纳入研究的犬在手术前有不同程度和持续时间的呼吸窘迫。中位手术时间为32分钟。中位住院时间为6小时,中位随访时间为427天。据主人在末次随访时报告,95.5%的犬术后长期呼吸功能改善;运动耐量提高了90%。主要并发症包括因吸入性肺炎导致的死亡(9%)、使用抗菌药物后3天内康复的吸入性肺炎(9%)以及右侧喉塌陷需要再次行右侧LI-UCAL(4.5%)。在长期随访中,95.5%的主人对手术结果满意。

结论

LI-UCAL是一种可行的手术技术,可改善与LP相关的临床症状。平稳恢复且无呼吸窘迫等不良反应与早期出院相关。LI-UCAL可被视为传统UCAL的替代方法。

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