Objective effectiveness of and indications for laser‐assisted turbinectomy in brachycephalic obstructive airway syndrome

• Published in: Veterinary surgery Vol. 48; no. 1; pp. 79 - 87
• Main Authors: Liu, Nai‐Chieh, Genain, Marie‐Aude, Kalmar, Lajos, Sargan, David R., Ladlow, Jane F.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.01.2019; Blackwell Publishing Ltd
• Subjects: Abnormalities; Airway Obstruction - therapy; Airway Obstruction - veterinary; Animals; Barometers; Computation; Computed tomography; Dog Diseases - therapy; Dogs; Entrances; Female; Laser Therapy - methods; Laser Therapy - veterinary; Lasers; Lesions; Male; Plethysmography; Population studies; Prospective Studies; Respiratory tract; Sneezing; Species Specificity; Surgery; Tissues; Treatment Outcome
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13107

Objective To evaluate the effectiveness of laser‐assisted turbinectomy (LATE) in treating brachycephalic obstructive airway syndrome (BOAS) and to investigate the potential indications. Study design Prospective clinical study. Sample population Client‐owned pugs, French bulldogs, and English bulldogs (n = 57). Methods A BOAS index was obtained from whole‐body barometric plethysmography before BOAS conventional multilevel surgery (CMS) and 2–6 months post‐CMS. Dogs with BOAS index >50% and BOAS functional grades II‐III after CMS were considered candidates for LATE. A BOAS index was repeated 2–6 months after LATE. Intranasal lesions and a measurement of soft tissue proportion at the rostral entrance of choanae (STC) were recorded on the basis of computed tomography images. Logistic regressions were used to assess the intranasal predictors for being LATE candidates. Results Twenty‐nine of 57 dogs were candidates for LATE, all of which were pugs or French bulldogs. The median BOAS index of dogs that were operated on (20/29 candidates) decreased from 67% post‐CMS to 42% after LATE (P < .001). Soft tissue proportion at the rostral entrance of choanae was the only predictor for candidacy for LATE. Pugs (P = .021; cutoff = 64%) and French bulldogs (P = .008; cutoff = 55%) with higher STC were more likely to be candidates for LATE. After LATE, 12 of 20 dogs had temporary episodes of reverse sneezing, and nasal noise was noted in 8 of 20 dogs when sniffing and excited. Conclusion Laser‐assisted turbinectomy was an effective treatment for dogs with intranasal abnormalities and a poor response to CMS. Soft tissue proportion at the rostral entrance of choanae was a predictor of candidacy for LATE in pugs and French bulldogs. Clinical significance Computed tomography‐based measurement of STC can be used to predict whether LATE is required in addition to CMS in pugs and French bulldogs with BOAS.