Subtotal Epiglottectomy and Ablation of Unilateral Arytenoid Cartilage as Surgical Treatments for Grade III Laryngeal Collapse in Dogs

SIMPLE SUMMARY: Laryngeal collapse is a condition characterized by the medial deviation of the cuneiform cartilage caused by upper airway obstruction. The condition is graded in three stages: stage III is defined as the collapse of the corniculate processes of the arytenoids and the destructuration of the dorsal portion of the rima glottidis. The surgical treatments for this condition include unilateral arytenoid laryngoplasty with cricoarytenoid lateralization combined with thyroarytenoid caudo-lateralization or permanent tracheostomy. Subtotal epiglottectomy was initially described for dogs with epiglottic retroversion. In the present study, subtotal epiglottectomy in association with the ablation of unilateral arytenoid cartilage is proposed as an alternative treatment for 16 dogs with stage III laryngeal collapse. The procedure aims to increase the air passage through the larynx, decrease negative intraglottic pressure, and reduce airway resistance. ABSTRACT: Stage III laryngeal collapse is defined as the collapse of the corniculate processes of the arytenoid cartilages and the destructuration of the dorsal portion of the rima glottidis. The primary cause is chronic upper airway obstruction, and the condition is often present in brachycephalic dogs. The treatment is still controversial; the patients are generally treated with a permanent tracheostomy. This article reports the authors’ experience with 16 dogs affected by stage III laryngeal collapse treated with subtotal epiglottectomy and the ablation of unilateral arytenoid cartilage. Before the surgery, all of the dogs underwent an effort test to classify the clinical severity of the disease and an endoscopic examination of the airways to determine the stage of severity of the laryngeal collapse. One month after surgery, the effort test was repeated in order to evaluate the clinical outcome. One year after surgery, the owners of 12 patients rated their dogs as follows: excellent in five cases, good in five cases, and fair in two cases. According to this pilot study, epiglottectomy associated with the photoablation of unilateral arytenoid cartilage increases airway flow, and thus may be considered a valid surgical procedure to treat dogs affected by grade III laryngeal collapse.