Page 108 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

Chapter 7 · Surger y of the lar ynx
Chapter 7 · Surgery of the larynx

➜ OPERATIVE TECHNIQUE 7.1 CONTINUED
VetBooks.ir 6 Two monofilament synthetic non-absorbable sutures are placed through the muscular process of the arytenoid

cartilage and the caudal one-third of the cricoid cartilage near the origin of the cricoarytenoideus muscle, to
mimic the function/action of the muscle.

7 The abduction is verified via intraoral visualization.

PRACTICAL TIP

The use of Lone Star ring retractors is helpful in providing exposure. Inadvertent penetration into the
laryngeal lumen and oesophageal laceration can be prevented by having a thorough knowledge of local
anatomy and using careful surgical technique with appropriate instruments. Do not lavage the surgical
site until the muscles are closed

PRACTICAL TIP

Fragmentation of the arytenoid is less likely to occur if the arytenoid is pulled into position towards the
caudal cricoid, after dissection and preplacement of the sutures, using an Allis forceps on the remnants of
the cricoarytenoideus dorsalis muscle instead of pulling on the sutures themselves. The arytenoid
cartilage is already abducted by the endotracheal tube, so avoid excessive caudal traction

Closure
The thyropharyngeal muscle can be apposed with a simple continuous pattern with absorbable material. The
subcutaneous tissues and the skin are closed routinely.

POSTOPERATIVE CARE

Postoperative care consists of close monitoring of the patient and providing broad-spectrum antibiotics and
analgesics. Monitor for complications such as haematoma formation, suture avulsion, discomfort during swallowing,
temporary glottic dysfunction and coughing after eating or drinking, sometimes resulting in aspiration pneumonia.

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