Table 1.
Treatment options for brachycephalic obstructive airway syndrome (BOAS)-related pathologies.
| Pathology | Surgical Treatments | Medical treatments | Comments |
|---|---|---|---|
| Stenotic nares | Vertical (Harvey 1982), horizontal (Leonard 1956), lateral (Monnet and Kudnig 2003) wedge alarplasty Alapexy (Ellison 2004) Punch resection alaplasty (Trostel and Frankel 2010) CO2 laser ablation (Mendes Junior et al. 2021) |
– | Rhinoplasty is recommended for puppies of 12–16 weeks of age to reduce the likelihood of secondary consequences of upper airway obstruction (Aron and Crowe 1985) |
| Elongated soft palate | Staphylectomy (electroscalpel (Knecht 1979), radiofrequency (Elkins 2005), CO2 laser (Clark and Sinibaldi 1994), bipolar sealing device (Davidson et al. 2001) Folded flap palatoplasty (Findji and Dupre 2008) H-pharyngoplasty (Carabalona et al. 2022) |
– | CO2 laser is the fastest technique (Davidson et al. 2001). Dogs <2 years of age treated with staphylectomy had better outcome than older dogs (Harvey 1982) H-pharyngoplasty may be suitable for most severely affected dogs (Carabalona et al. 2022). |
| Everted tonsils | Tonsillectomy (Fasanella et al. 2010) | – | Rarely performed due to unclear benefit (Poncet et al. 2005) |
| Everted laryngeal saccules | Sacculectomy (Harvey 1982) | – | Clinical improvement post sacculectomy only in 40% of cases (Lorinson et al. 1997) |
| Laryngeal collapse | Arytenoidectomy (Wykes 1991) Partial laryngectomy, laryngeal tieback, tracheostomy (Johnston and Tobias 2017) |
Weight loss (Thomason et al. 2016) Exercise restriction (Welcome 2008) |
Laryngeal collapse is challenging to manage with aspiration pneumonia being most common complication (Harvey 1982) Laryngotomy and tracheostomy are salvage procedures (Johnston and Tobias 2017) |
| Middle ear effusion (MEE) | Tympanostomy tube placement (Guerin et al. 2015) | Local and systemic corticosteroids, amitriptyline, antihistamines, N-acetylcysteine (Milne et al. 2020) | MEE can be subclinical, or associated with vestibular signs (Guerin et al. 2015) |
| Hiatal hernia (HH) | Oesophagopexy (Johnston and Tobias 2017) Gastropexy (Johnston and Tobias 2017) |
Proton pump inhibitor, cisapride, feeding management (Hwang et al. 2017) | – |
| Reflux oesophagitis | – | Proton pump inhibitor, cisapride, sucralfate (Kook 2021) | – |
| Systemic hypertension | – | Calcium channel blocker, ACEI, ARB (Acierno et al. 2018) | Evaluate for concurrent causes of secondary hypertension (Acierno et al. 2018) |
| Hypercoagulability | – | Antiplatelet therapy (Thomason et al. 2016) | – |