- A wedge of tissue is removed from the area next to the nostril and sutured close.
- Surgery does not change the shape of the nose itself, and the result is cosmetically pleasing if the correct method is utilised. There are a few techniques that can be done.
Elongated Soft Palate
There are two methods to shorten soft palates.
- The common method is to resect with surgical scissors and over-sew the end of the palate. A more modern and better method is called ligasure (a state of the art electrosurgical vessel sealing device), which is a surgical unit that resects the palate without the need of suturing, and takes a fraction of the time (hence your dog is under anaesthesia for a lot less time). Recovery is more comfortable without dissolving sutures in place for some months. Ligasure also minimises surgical trauma and swelling that suturing may cause, also improving recovery. Southern Animal Health is one of the few clinics that use Ligasure for palate shortening. Although suturing is still absolutely fine, it is a question you can ask – whether ligasure or suturing is used.
- Thick palates that need to be thinned are dealt with differently. A procedure called a folding palatoplasty is used, during which the thickened palatine muscle is excised, and the remaining part of the soft palate is folded forward and sutured. The end result is not only a shorter palate, but a much thinner one which allows for significantly easier breathing again.
Everted Laryngeal Saccules
Each saccule (there are two) is grasped with tissue forceps and excised at its base. No sutures are required.
- Bleeding is minimal but actually controlled by the endotracheal tube that is subsequently placed.
- This procedure needs to be done prior to entubating immediately after the patient is induced with injectable anaesthesia. Hence the surgeon needs to be skilled and quick in order to do an excellent job. Many surgeons that don’t do palate shortening may not do laryngeal saccules removal. Hence in your research for finding a good surgeon you must ask about their experience and ability to remove everted saccules if present.
- If they are greatly swollen due to BOAS, the tonsils should be removed
- In our practice they are removed using the Ligasure equipment, precluding the need for suturing. Otherwise most practices cut them out and suture (which is reasonable), but more time consuming and inflammatory post surgery.