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Clarke et al: Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs
Veterinary Surgery 6, 2022

🔍 Key Findings

  • Nasopharyngeal collapse was significantly more severe in brachycephalic dogs (median 65%) than in nonbrachycephalic controls (median 10%) (p = .0001).
  • Postoperative fluoroscopy showed no significant improvement in nasopharyngeal collapse (p = .0505), despite reported clinical improvement.
  • 70% of brachycephalic dogs had ≥50% collapse; 26% had 100% collapse preoperatively.
  • All owners of surgical cases reported clinical improvement, including reduced respiratory noise and improved exercise tolerance.
  • Surgical techniques used included combinations of alaplasty, staphylectomy, sacculectomy, and tonsillectomy.
  • Improvement in nasopharyngeal dimensions was variable, with some dogs improving ≥45%, some worsening, and one dog showing a 100% increase post-op.
  • Pharyngeal collapse may not be solely anatomical; neuromuscular dysfunction (e.g., reduced pharyngeal dilator muscle function) may contribute.
  • Current surgical techniques may not address functional airway abnormalities, suggesting a need for multimodal or targeted interventions.

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← Articles

Clarke et al: Severity of nasopharyngeal collapse before and after corrective upper airway surgery in brachycephalic dogs
Veterinary Surgery 6, 2022

🔍 Key Findings

  • Nasopharyngeal collapse was significantly more severe in brachycephalic dogs (median 65%) than in nonbrachycephalic controls (median 10%) (p = .0001).
  • Postoperative fluoroscopy showed no significant improvement in nasopharyngeal collapse (p = .0505), despite reported clinical improvement.
  • 70% of brachycephalic dogs had ≥50% collapse; 26% had 100% collapse preoperatively.
  • All owners of surgical cases reported clinical improvement, including reduced respiratory noise and improved exercise tolerance.
  • Surgical techniques used included combinations of alaplasty, staphylectomy, sacculectomy, and tonsillectomy.
  • Improvement in nasopharyngeal dimensions was variable, with some dogs improving ≥45%, some worsening, and one dog showing a 100% increase post-op.
  • Pharyngeal collapse may not be solely anatomical; neuromuscular dysfunction (e.g., reduced pharyngeal dilator muscle function) may contribute.
  • Current surgical techniques may not address functional airway abnormalities, suggesting a need for multimodal or targeted interventions.

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Multiple Choice Questions on this study

In Clarke 2022 et al., on nasopharyngeal collapse severity, which median percentage collapse was found in brachycephalic dogs preoperatively?

A. 10%
B. 26%
C. 42%
D. 65%
E. 90%

Answer: 65%

Explanation: Median preoperative nasopharyngeal collapse in brachycephalic dogs was 65%, significantly higher than in controls.
In Clarke 2022 et al., on nasopharyngeal collapse severity, which of the following surgeries was NOT part of the standard corrective procedures performed?

A. Staphylectomy
B. Alaplasty
C. Sacculectomy
D. Tonsillectomy
E. Tracheal stenting

Answer: Tracheal stenting

Explanation: Tracheal stenting was not part of the standard surgical interventions used in this cohort.
In Clarke 2022 et al., on nasopharyngeal collapse severity, which diagnostic modality was used to quantify pharyngeal collapse in awake dogs?

A. CT imaging
B. Videolaryngoscopy
C. Fluoroscopy
D. MRI
E. Transnasal endoscopy

Answer: Fluoroscopy

Explanation: Fluoroscopy was used to measure nasopharyngeal dimensions during respiration.
In Clarke 2022 et al., on nasopharyngeal collapse severity, what was the statistical outcome of comparing pre- and postoperative collapse measurements?

A. Significant improvement (p < .01)
B. Significant worsening (p < .01)
C. No change (p > .5)
D. Mild improvement, not statistically significant (p = .0505)
E. Improvement with high confidence (p = .005)

Answer: Mild improvement, not statistically significant (p = .0505)

Explanation: The comparison yielded a p-value of .0505, suggesting a trend but not statistical significance.
In Clarke 2022 et al., on nasopharyngeal collapse severity, what explanation was proposed for lack of improvement in some dogs after surgery?

A. Poor anesthetic recovery
B. Recurrent nasal obstruction
C. Persistent soft palate elongation
D. Inadequate airway dilator muscle function
E. Infection of surgical site

Answer: Inadequate airway dilator muscle function

Explanation: Neuromuscular dysfunction was suggested as a possible reason why some dogs did not show improved nasopharyngeal patency post-op.

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