This article is part of the WSAVA Global Edition of Clinician's Brief.
Canine brachycephalic syndrome (BS) consists of anatomic abnormalities (eg, stenotic nares, tortuous nasal cavities, aberrant conchae, elongated soft palate [ESP], everted laryngeal saccules, laryngeal collapse, tracheal hypoplasia) of brachycephalic dogs, which can lead to obstructive dyspnea and digestive disorders. In one study, 97% of brachycephalic dogs presented for BS had concurrent GI diseases.1 Upper obstructions (eg, nares, conchae, soft palate) may aggravate and sometimes cause deeper obstructions (eg, laryngeal, tracheal, bronchial collapses) and digestive disorders.
Early surgical correction of these abnormalities is often recommended and commonly includes treatment for stenotic nares and ESP. Other abnormalities (eg, laryngeal collapse2) occasionally require surgical attention but rarely in first intention. ESP, the most consistent anatomic abnormality encountered in dogs with BS, has been reported in up to 100% of cases.3,4 Initially, ESP was primarily described as excessive soft palate length, which can cause obstruction of the rima glottidis on inspiration (laryngeal obstruction). However, in many brachycephalic dogs, it has long been observed5-11 and recently demonstrated12,13 that the soft palate is also excessively thick, adding nasopharyngeal and oropharyngeal components to airway obstruction.
Related Article: Surgeon’s Corner: Soft Palate & Stenotic Nares Resection for Brachycephalic Dogs
Folded flap palatoplasty (FFP) was developed to address the three components of obstruction caused by the soft palate by making it both thinner and shorter.8,9-11 Stenotic nares, when present, should be corrected following FFP. Various techniques have been described, but the authors prefer vertical wedge alaplasty, which consists of excising a vertical wedge from the ala nasi.