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In this episode, host Alyssa Watson, DVM, welcomes back Karen M. Tobias, DVM, MS, DACVS, to discuss her recent Clinician’s Brief article, “Maximizing Air Flow Through Stenotic Nares via Ala Vestibuloplasty.” While many find the nasal anatomy confusing and this surgical procedure intimidating, Dr. Tobias guides us through this highly practical approach, demystifying the surgery along the way.
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Key Takeaways
There is an entire compilation of factors that contribute to upper respiratory occlusion in brachycephalic breeds; addressing the stenotic nares is just one factor.
The alar wing is the external part of the lateral nasal planum on either side, whereas the alar fold is more internal, extending medially from the alar wing to the septum is what we’re trying to resect.
This technique requires two or three scalpel cuts using an 11-blade while you grasp the alar fold; start ventromedially and sweep dorsolaterally to sever the medial attachment, then progress ventrolaterally to get the attachment to the alar wing. You can practice using a modified tongue depressor to get the feel.
Remember to use a vasoconstricting drop, but still expect bleeding as soon as cutting starts.
This technique can also disrupt a channel of the nasolacrimal duct, so warn clients about potential ocular discharge post-op.
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The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Multimedia Specialist