Brachycephalic Patients
What Does Brachycephalic Mean?
The term “brachycephalic” is derived from the Greek words “brachy,” meaning shortened, and “cephalic,” meaning head. Brachycephalic dogs are characterized by skull bones that are shortened in length, resulting in a distinctively pushed-in appearance of the face and nose. This alteration in skull shape affects the anatomy of the upper airway and the relationships among various soft tissue structures, which can lead to physical health issues for the affected dogs.
Common brachycephalic breeds include:
- French Bulldogs
- English Bulldogs
- Boxer Dogs
- Boston Terriers
- Pekingese
- Chinese Shar-Pei
- Pugs
- Lhasa Apsos
- Shih Tzus
- Bull Mastiffs
What Are the Corrective Procedures to Remedy Bracycephalic Obstructive Airway Syndrome (BOAS)?
Corrective airway surgery is a specialized procedure designed to enhance respiratory function in pets with obstructed airways. This surgery typically involves several key interventions, including:
- Nasal Vestibuloplasty:
Widening the entrance to each nostril to alleviate restrictions that hinder airflow. This procedure aims to create a more open passage for breathing.
- Tissue Reduction:
Removal of excessive nasal tissue within each nostril. This step helps to eliminate any tissue buildup that may contribute to airway obstruction.
- Tonsillectomy and Sacculotomy:
Removal of enlarged tonsils and laryngeal saccules, which can obstruct the airway when swollen. These structures can interfere with airflow and contribute to respiratory distress.
- Soft Palate Resection:
Reduction of excessive tissue from an elongated soft palate that may obstruct airflow during respiration. By shortening the soft palate, we enhance airway patency and improve overall breathing.
Upper Airway Abnormalities in Brachycephalic Dogs
- Stenotic Nares:
Dogs with this condition have abnormally narrowed or small nostrils, which restrict airflow into the nasal passages.
- Extended Nasopharyngeal Turbinates:
Dogs with this condition have abnormally narrowed or small nostrils, which restrict airflow into the nasal passages.
- Elongated Soft Palate:
An elongated soft palate, which is the soft tissue at the back of the roof of the mouth, is too long for the mouth length and partially obstructs the trachea (windpipe).
- Laryngeal Collapse:
Chronic stress on the laryngeal cartilage from other brachycephalic features may result in laryngeal collapse, restricting normal airflow.
- Everted Laryngeal Saccules:
Laryngeal saccules, located just inside the larynx, can evert (turn outwards) or get sucked into the airway due to increased respiratory effort, further obstructing airflow.
- Hypoplastic Trachea:
A hypoplastic trachea is characterized by a smaller-than-normal diameter of the trachea, contributing to breathing difficulties.
Nasal Vestibuloplasty
Widening the entrance to each nostril to alleviate restrictions that hinder airflow. This procedure aims to create a more open passage for breathing.
Tissue Reduction
Removal of excessive nasal tissue within each nostril. This step helps to eliminate any tissue buildup that may contribute to airway obstruction.
Video of a staphlectomy (repair of an elongated soft palate) pre surgery and post operatively
Pre
Post
Video credit Dr. Jose Gorostiza