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Surgeon's Corner: Soft Palate & Stenotic Nares Resection for Brachycephalic Dogs

Howard B Seim III, DVM, DACVS

Surgery, Soft Tissue

|February 2013

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Presentation

A French bulldog presented with airway obstruction and subsequent regurgitation.

​​​​​​​Surgery

Soft Palate Resection

Under general anesthesia, the patient was placed in sternal recumbency with the mouth held wide open. An identifying mark was made on the soft palate where the tip of the epiglottis reaches the palate. This is the area for an ideal resection. Stay sutures were placed in the right and left commissures of the soft palate, as well as at the tip of the palate to manipulate the soft palate during resection. It is important to make the incision in small bites, taking one-third to one-half of the proposed incision area off at one time, leaving the remaining aspect of the palate attached.

The oral and nasal mucosa should be seamlessly apposed (allowing for adequate suture pressure to encourage hemostasis) and closed with synthetic braided absorbable suture in a simple continuous pattern. The remaining sections of the soft palate are resected and closure is performed in the same manner, creating a water-tight seal with the oral and nasal mucosa. The tip of the epiglottis is gently manipulated against the cut edge of the remaining soft palate to ensure the proper amount has been removed, allowing the tip of the epiglottis to just “kiss” the cut edge of the palate.

Stenotic Nares Repair

The stenotic nares in this dog created a dramatic occlusion. The surgeon used a #11 blade to ensure a deep dissection of the occluding nares. A segment of the nares was removed and a gauze sponge used for hemostasis, taking about 15 to 20 minutes.

Outcome

One day following surgery, the patient was breathing with his mouth closed and had complete resolution of signs.

This video was authored by Howard B Seim III, DVM, DACVS. Other surgical videos are available through VideoVet. Surgeon’s Corner is intended as a forum for those with specialized expertise to share their approaches to various techniques and procedures. As such, the content reflects one expert’s approach and is not subject to peer review.

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