Dogs that have laryngeal paralysis lack the ability to open their upper airway when they inhale. This occurs because the muscles that pull the arytenoid cartilages to either side during inhalation do not contract. The preferred surgical technique for treating this problem is called a cricoarytenoid lateralization. Prior to preparing these patients for surgery, a complete orolaryngeal examination is performed to make certain of the diagnosis and to make sure that there are no other abnormalities such as tumors or tonsillar enlargement.
To perform this procedure, a surgical approach is made to the larynx through the side of the neck. Once the larynx is exposed, a heavy, permanent suture is placed from the cricoid cartilage of the larynx to the muscular process of the arytenoid cartilage of the larynx. Once this suture is tied, the arytenoid cartilage is pulled to one side thus increasing the functional opening of the larynx. The surgical approach is then closed. Prior to recovering the patient from anesthesia, the laryngeal examination is repeated to be certain that the laryngeal opening is sufficient.
The most noteworthy complication following this procedure is aspiration pneumonia. That is a condition in which something other than air, i.e. food or water, makes its way through the laryngeal opening and down to the lungs thus precipitating an infection. If diagnosed early, this aspiration pneumonia is treatable. If left untreated, it will be lethal. As such, it is imperative that pet owners be cognizant of the clinical signs associated with aspiration. The most common clinical signs associated with aspiration pneumonia are depression and anorexia. As such, if a patient has had a cricoarytenoid lateralization and becomes depressed or goes off of its feed, he or she should be seen by their veterinarian as soon as possible. Do not wait a day or two to see if things improve. This procedure will alter the orientation of the vocal cords and this will result in a loss of the pet’s ability to bark loudly. They essentially lose their voices permanently. Interestingly, most patients have an abnormal bark prior to surgery.
What does the post-operative care entail?
Do we do the surgery on both sides?
No. Doing the procedure on both sides increases the risk of aspiration pneumonia dramatically and does not provide an appreciable functional increase the diameter of the airway.
What is the prognosis following this procedure?
The prognosis is very good following this procedure. The results are immediate and it can truly increase the quality of life for those patients that warrant it.