canis - Articles
Larynx: laryngeal tie-back technique
Synonym(s): Unilateral arytenoid lateralization
Introduction
- Enlargement of the rima glottidis by surgical abduction of the arytenoid cartilage.
- Generally performed unilaterally. If the surgical technique is good monolateral tie-back permits a sufficient increase of the glottis diameter.
- May be performed bilaterally depending on the relative increase in glottis diameter required to produce an airway of adequate size yet prevent aspiration.
Dogs that undergo bilateral tieback are significantly more likely to develop complications and less likely to survive than dogs that undergo unilateral tie-back.
Uses
- Treatment of laryngeal paralysis Larynx: paralysis , especially in medium and large dog breeds, but may be performed in any size dog.
Advantages
- Good results in most cases (>90%).
- Relatively few complications.
- No need for routine tracheostomy Tracheostomy: temporary post-operatively.
Alternative techniques
- Conservative (medical) treatment in small dogs/very mild cases.
- Excision of vocal folds - simple, but stenosis may result.
- Partial laryngectomy - high complication rate.
- Castellated laryngofissure procedure - technically difficult.
- Re-innervation procedures - improvement takes many (8-10) months.
- Transoral partial arytenoidectomy.
Time required
Preparation
- 15 minutes.
Procedure
- 1 hour.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Hammel S P, Hottinger H A & Novo R E (2006) Postoperative results of unilateral arytenoid lateralization for treatment of idiopathic laryngeal paralysis in dogs: 39 cases (1996-2002). JAVMA 228 (8), 1215-1220 PubMed.
- MacPhail C M & Monnet E (2001) Outcome of and postoperative complications in dogs undergoing surgical treatment of laryngeal paralysis - 140 cases (1985-1998). JAVMA 218 (12), 1949-1956 PubMed.
- Peterson S W, Rosin E & Bjorling D E (1991) Surgical options for laryngeal paralysis in dogs - a consideration for partial laryngectomy. Comp Cont Educ Pract Vet 13 (10), 1531-40 VetMedResource.
- LaHue T R (1989) Treatment of laryngeal paralysis in dogs by unilateral cricoarytenoid layngoplasty. JAAHA 25 (3), 317-24 ResearchGate.
- White R A S (1989) Unilateral arytenoid lateralization - an assessment of technique and long term results in 62 dogs with laryngeal paralysis. JSAP 30 (10), 543-9 Wiley Online Library.