Abordagem cirúrgica ao síndrome braquicefálico em cães: descrição de 4 casos clínicos
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2022
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O BOAS (‘brachycephalic obstructive airway syndrome’) é um problema cada vez mais atual e presente na prática clínica médico-veterinária, devido à seleção genética de cães com características braquicefálicas cada vez mais extremas. Os seus principais componentes são a estenose das narinas e hiperplasia do palato mole. Contudo, podem existir outras alterações presentes como o colapso da laringe, presença de turbinados aberrantes, hipoplasia traqueal e eversão/hipertrofia das amígdalas. Os sinais clínicos mais comuns são estridores e roncos, dispneia inspiratória, hipertermia, apneia de sono, intolerância ao exercício, episódios de cianose e sincopes. Estes nem sempre são interpretados como problemáticos, uma vez que são vistos como normais para a raça. Para além dos sinais respiratórios, o BOAS também provoca alterações gastrointestinais. De forma a identificar a severidade do BOAS e definir o melhor plano cirúrgico é necessário um bom exame físico e avaliação da laringe, assim como realizar exames complementares de diagnóstico, tais como, radiografia, tomografia computorizada, fluoroscopia e endoscopia. O tratamento cirúrgico varia de acordo com as alterações presentes em cada caso e também com as preferências de cada cirurgião, uma vez que existem diversas técnicas para corrigir cada componente do BOAS. Apesar da maioria dos cães beneficiarem com a correção cirúrgica, continuam sempre com algum grau de comprometimento respiratório. Neste relatório de estágio encontram-se descritos 4 casos clínicos de cirurgia de correção do BOAS em cães, assim como a revisão bibliográfica das diferentes técnicas cirúrgicas que podem ser utilizadas.
Palavras-chave: BOAS; braquicefálicas; estenose das narinas; hiperplasia do palato mole; estridores e roncos; dispneia inspiratória
BOAS (‘brachycephalic obstructive airway syndrome’) is an increasingly current problem and present in veterinary clinical practice, due to the genetic selection of dogs with extreme brachycephalic characteristics. Its main components are stenotic nares and soft palate hyperplasia. However, there may be other alterations present, such as laryngeal collapse, aberrant nasopharyngeal turbinates, tracheal hypoplasia, and tonsil eversion/hypertrophy. The most common clinical signs are stridor and snoring, inspiratory dyspnea, hyperthermia, sleep apnea, exercise intolerance, episodes of cyanosis and syncope. These are not always interpreted as problematic, as they are seen as normal for the breed. In addition to respiratory signs, BOAS also causes gastrointestinal changes. To identify the severity of BOAS and define the best surgical plan, a good physical examination and evaluation of the larynx are necessary, as well as complementary diagnostic tests, such as radiography, computed tomography, fluoroscopy, and endoscopy. Surgical treatment varies according to the changes present in each case and to the preferences of each surgeon since there are several techniques to correct each component of BOAS. Although most dogs benefit from surgical correction, they always continue to have some degree of respiratory compromise. In this internship report, 4 cases of BOAS correction surgery in dogs will be described, as well as a literature review of the different surgical techniques that can be used. Keywords: BOAS; brachycephalic; stenotic nares; soft palate hyperplasia; stridor and snoring; inspiratory dyspnea
BOAS (‘brachycephalic obstructive airway syndrome’) is an increasingly current problem and present in veterinary clinical practice, due to the genetic selection of dogs with extreme brachycephalic characteristics. Its main components are stenotic nares and soft palate hyperplasia. However, there may be other alterations present, such as laryngeal collapse, aberrant nasopharyngeal turbinates, tracheal hypoplasia, and tonsil eversion/hypertrophy. The most common clinical signs are stridor and snoring, inspiratory dyspnea, hyperthermia, sleep apnea, exercise intolerance, episodes of cyanosis and syncope. These are not always interpreted as problematic, as they are seen as normal for the breed. In addition to respiratory signs, BOAS also causes gastrointestinal changes. To identify the severity of BOAS and define the best surgical plan, a good physical examination and evaluation of the larynx are necessary, as well as complementary diagnostic tests, such as radiography, computed tomography, fluoroscopy, and endoscopy. Surgical treatment varies according to the changes present in each case and to the preferences of each surgeon since there are several techniques to correct each component of BOAS. Although most dogs benefit from surgical correction, they always continue to have some degree of respiratory compromise. In this internship report, 4 cases of BOAS correction surgery in dogs will be described, as well as a literature review of the different surgical techniques that can be used. Keywords: BOAS; brachycephalic; stenotic nares; soft palate hyperplasia; stridor and snoring; inspiratory dyspnea
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Orientação: João Martins
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MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, MEDICINA VETERINÁRIA, VETERINARY MEDICINE, CASOS CLÍNICOS, CASE REPORTS, CÃES, DOGS, SÍNDROME BRAQUICEFÁLICO RESPIRATÓRIO OBSTRUTIVO, BRACHYCEPHALIC OBSTRUCTIVE AIRWAY SYNDROME