J Am Vet Med Assoc. 2022 Mar 30;260(12):1-4. doi: 10.2460/javma.21.07.0350.
5 dogs with a history of ventriculocordectomy were anesthetized with isoflurane for ovariohysterectomy, dental prophylaxis, or intracapsular lens extraction.
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.
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.
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.
5 只曾行脑室-声带切除术的犬因卵巢子宫切除术、牙齿保健或囊内晶状体取出术而接受异氟烷麻醉。
4 只犬无明显异常临床症状，如运动不耐受、呼吸困难或喘鸣。然而，1 只犬在饮水后出现咳嗽，该症状始于脑室-声带切除术之后。在插管过程中，意外发现疑似脑室-声带切除术的并发症喉蹼。
在插管过程中观察到喉蹼，需要使用较小直径的气管内导管（ETT）进行插管。然而，较小 ETT 的较小套囊容积无法防止漏气。因此，将带充气套囊的 ETT 向头侧拉动，直到套囊在声带后面阻塞狭窄的喉腔。将 ETT 固定以防止滑动。在任何一只犬的围麻醉期，均未观察到 ETT 套囊周围漏气或与 ETT 放置相关的并发症。
曾有喉部相关手术史的患者可能会发现喉蹼，仅允许较小直径的 ETT 通过。此处描述的用于经小 ETT 套囊周围漏气密封的密封技术，可在不引起并发症的情况下，有效地密封套囊周围的漏气。
