DOI
https://doi.org/10.18849/ve.v10i3.716Abstract
PICO Question
In dogs undergoing brachycephalic obstructive airway syndrome (BOAS) surgery, is folded-flap palatoplasty associated with fewer complications and earlier discharge time compared with staphylectomy techniques?
Clinical bottom line
Category of research
Risk.
Number and type of study designs reviewed
Two retrospective cohort studies compared outcomes of folded-flap palatoplasty and staphylectomy. One study performed staphylectomy using the standard cut-and-sew technique, while the other used a CO2 laser. Folded-flap palatoplasty was carried out using the standard technique described in the literature in both studies.
Strength of evidence
Weak.
Outcomes reported
While one study reports similar outcomes in minor and major complications between folded-flap palatoplasty and staphylectomy, with both procedures having comparable hospitalisation durations, another study identifies staphylectomy as one of four factors associated with a complicated recovery, along with increasing age, higher grades of laryngeal collapse, and prolonged anaesthesia time.
Conclusion
To date, there is weak evidence suggesting that staphylectomy may be one of the risk factors for perioperative complications in dogs undergoing surgery for an elongated soft palate. This potential risk should be considered during surgical planning and immediate postoperative period.
References
Brdecka, D.J., Rawlings, C.A., Perry, A.C. & Anderson, J.R. (2008). Use of an electrothermal, feedback-controlled, bipolar sealing device for resection of the elongated portion of the soft palate in dogs with obstructive upper airway disease. Journal of the American Veterinary Medical Association. 233(8), 1265–1269. DOI: https://doi.org/10.2460/javma.233.8.1265
Davidson, E.B., Davis, M.S., Campbell, G.A., Williamson, K.K., Payton, M.E., Healey, T.S. & Bartels, K.E. (2001). Evaluation of carbon dioxide laser and conventional incisional techniques for resection of soft palates in brachycephalic dogs. Journal of the American Veterinary Medical Association. 219(6), 776–781. DOI: https://doi.org/10.2460/javma.2001.219.776
Dupré, G. & Heidenreich, D. (2016). Brachycephalic Syndrome. Veterinary Clinics of North America: Small Animal Practice. 46(4), 691–707. DOI: https://doi.org/10.1016/j.cvsm.2016.02.002
Findji, L. & Dupré, G. (2008). Folded flap palatoplasty for treatment of elongated soft palates in 55 dogs. Wiener Tierärztliche Monatsschrift - Veterinary Medicine Austria. 95, 56-63.
Fracka, A.B., Song, M.K., Dejong, T.L. & Fransson, B.A. (2024). Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018–2022). Veterinary Surgery. 53(4), 630–641. DOI: https://doi.org/10.1111/vsu.14086
Khoo, T-X., Yates, G., Chambers, B. & Ng, J. (2022). Wound healing complications following folded flap palatoplasty in brachycephalic dogs. Australian Veterinary Journal. 100(12), 571–578. DOI: https://doi.org/10.1111/avj.13204
Liu, N-C., Oechtering, G.U., Adams, V.J., Kalmar, L., Sargan, D.R. & Ladlow, J.F. (2017). Outcomes and prognostic factors of surgical treatments for brachycephalic obstructive airway syndrome in 3 breeds. Veterinary Surgery. 46(2), 271–280. DOI: https://doi.org/10.1111/vsu.12608
Mercurio, A. (2011). Complications of upper airway surgery in companion animals. Veterinary Clinics of North America: Small Animal Practice. 41(5), 969–980. DOI: https://doi.org/10.1016/j.cvsm.2011.05.016
Miller, A.K., Regier, P.J. & Colee, J.C. (2024). Complications and outcome following staphylectomy and folded flap palatoplasty in dogs with brachycephalic obstructive airway syndrome. Veterinary Surgery. 53(1), 29–37. DOI: https://doi.org/10.1111/vsu.13994
Oechtering, T.H., Oechtering, G.U. & Nöller, C. (2007). Structural characteristics of the nose in brachycephalic dog breeds analysed by computed tomography. Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere. 35(3), 177–187. DOI: https://doi.org/10.1055/s-0038-1622615
Reiter, A.M. & Holt, D.E. (2018). Palate. In: S.A. Johnston & K.M. Tobias, ed., Veterinary Surgery: Small Animal (vol. 1), 2nd ed. St. Louis: Elsevier, 1935–1946.
Riecks, T.W., Birchard, S.J. & Stephens, J.A. (2007). Surgical correction of brachycephalic syndrome in dogs: 62 cases (1991-2004). Journal of the American Veterinary Medical Association. 230(9), 1324–1328. DOI: https://doi.org/10.2460/javma.230.9.1324
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