Comparison of the effectiveness of three different rhinoplasty techniques to correct stenotic nostrils using silicone models: A case study.

OBJECTIVE: To compare the effects of three different rhinoplasty techniques on the postoperative cross-sectional areas (CSAs) of the nares and nasal vestibuli. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Ninety-nine 3D-printed, remolded silicone models of a single French bulldog's rostral nose. METHODS: Models were fabricated based on a computed tomographic (CT) scan of the nose of a French bulldog with moderately stenotic nares. Each model underwent either vertical wedge resection (VW), modified horizontal wedge resection (MHW), or ala-vestibuloplasty (AVP) performed by a single surgeon (n = 33 per group). Preoperative and postoperative CT scans of the models were performed, and CSAs of the airway from the nares to the caudal end of the nasal vestibules were calculated. RESULTS: All three rhinoplasty techniques increased CSAs (adjusted p values <.001) but to different levels caudally within the nasal vestibule. Vertical wedge resection achieved this up to the start of the alar fold, MHW up to halfway between the nares and the alar fold and AVP up to the caudal nasal vestibule. Average percentage increases in CSA were 26%, 15% and 74%, respectively. Ala-vestibuloplasty led to larger CSAs than VW and MHW from the nares to the caudal nasal vestibule (adjusted p values <.05). The proportional difference within each technique was <7%. CONCLUSION: Ala-vestibuloplasty resulted in a larger increase in the airway CSA of silicone modeled nares and nasal vestibules of a single French bulldog in comparison with VW and MHW. CLINICAL SIGNIFICANCE: Ala-vestibuloplasty can be considered for French bulldogs with moderately stenotic nares and evidence of nasal vestibular stenosis.

Complications and outcomes of cats with coxofemoral luxation treated with hip toggle stabilization using ultrahigh-molecular-weight-polyethylene or nylon (2009-2018): 48 cats.

OBJECTIVE: To report overall rate and type of complications and outcomes of cats with coxofemoral luxation managed with hip toggle stabilization (HTS), to compare rate of postoperative complications and outcomes of cats treated with ultrahigh-molecular-weight-polyethylene (UHMWPE) or nylon, and to identify risk factors for reluxation and non-excellent outcomes. STUDY DESIGN: Multi-institutional retrospective cohort study. SAMPLE POPULATION: Forty-eight client-owned cats. METHODS: Medical records of cats that underwent HTS from 2008-2018 using UHMWPE or nylon were reviewed. Univariable and multivariable logistic regression was performed to assess for factors associated with reluxation and non-excellent outcome. Final outcome was obtained from owner questionnaire. RESULTS: Intraoperative and postoperative complications were recorded in two (4.2%) and 11 (24.4%) cats, respectively. The most common postoperative complication was reluxation (n = 5 [11.1%]). Outcome was classified as excellent in 81.1% and good in 16.2% of cats after a median of 445.5 days (range, 53-3720). No difference in rate of complications or outcomes was identified between UHMWPE and nylon. Performance of additional orthopedic procedures, occurrence of intraoperative complications, and non-performance of capsulorrhaphy were associated with reluxation. Performance of additional non-hip procedures (orthopedic/nonorthopedic) was associated with non-excellent outcome. CONCLUSION: Hip toggle stabilization was associated with a low rate of intraoperative complications and reluxation and excellent long-term outcomes in most cats. No difference in rate of postoperative complications or outcomes of cats treated using UHMWPE or nylon was identified. Cats that underwent additional orthopedic procedures had greater risk of reluxation. CLINICAL SIGNIFICANCE: Hip toggle stabilization is an effective technique for management of coxofemoral luxation in cats. Comparable results are expected using UHMWPE or nylon.

Nebulization of epinephrine to reduce the severity of brachycephalic obstructive airway syndrome in dogs.

OBJECTIVE: To determine the preoperative and postoperative effect of nebulized epinephrine on brachycephalic obstructive airway syndrome (BOAS) severity in dogs. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Thirty-one client-owned pugs, French bulldogs, and English bulldogs with moderate to severe BOAS. METHODS: Whole body barometric plethysmography was used to determine BOAS severity (BOAS index; 0%-100%) prior to and after nebulization with 0.05 mg/kg epinephrine diluted in 0.9% saline preoperatively. The same protocol was repeated postoperatively (within 24 hours of surgery). RESULTS: Five dogs were excluded because they did not tolerate nebulization, and postoperative data were available for 13 dogs. Epinephrine nebulization resulted in a decreased BOAS index across all breeds of dog both before (9.6% [3.1% to -30.2%], n = 26) and after surgery (14.3% [0.9% to -24.3%], n = 13). The preoperative reduction in BOAS index was greater (17.3% [1.8% to -27.4%]) in dogs with a baseline BOAS index >70% (P = .006) and in pugs (16.9% [0.8% to -27.4%]) compared with French bulldogs (5.2% [3.1% to -30.2%], P = .03). Simple linear regression was used to identify a positive relationship between baseline BOAS index and reduction in BOAS index for pugs (n = 10, P = .001). Nausea was noted as a side effect in four dogs. CONCLUSION: Nebulized epinephrine reduced the BOAS index of dogs in this study. This effect was clinically significant in preoperative dogs with a BOAS index >70% and in dogs recovering from surgery. CLINICAL SIGNIFICANCE: This study provides evidence to support the use of nebulized epinephrine in the perioperative management of BOAS-affected dogs.