Laryngeal paralysis yog ib yam kab mob uas cuam tshuam rau cov kab mob ua pa sab saud uas cov pob txha mos ntawm cov pob txha mos tsis qhib (abduct) kom raug thaum muaj kev tshoov siab. Nws tuaj yeem muaj lub hauv paus los yog tau txais keeb kwm thiab, dhau los, tuaj yeem yog unilateral lossis ob sab. Hauv cov tsiaj uas nyob twj ywm asymptomatic, tsis tas yuav kho. Txawm li cas los xij, nyob rau hauv cov neeg mob uas tus kab mob ua rau ua pa tsis txaus uas cuam tshuam rau lub neej zoo thiab kev noj qab haus huv ntawm tus tsiaj, nws yog ib qho tsim nyog yuav tsum tau ua qhov kev kho mob kom zoo.
Yog koj xav paub ntxiv txog laryngeal paralysis in dogs, mus nyeem cov lus hauv qab no ntawm peb qhov chaw uas peb piav qhia nws cov tsos mob dab tsi, ua thiab kho.
laryngeal paralysis hauv dev yog dab tsi?
Laryngeal paralysis is an obstructive disorder of the upper airways in which the arytenoid cartilages of the larynx tsis qhib (abduct) kom raug thaum lub sij hawm. kev tshoov siab, vim poob ntawm innervation ntawm dorsal cricoarytenoid leeg.
Cov leeg dorsal cricoarytenoid yog lub luag haujlwm rau kev txav ntawm lub larynx. Thaum lub innervation ntawm cov leeg no ploj lawm, nws contraction yog inhibited thiab nws atrophies. Yog li ntawd, cov pob txha arytenoid ntawm lub larynx tsis qhib kom zoo thiab rhyma glottis (qhib ntawm lub larynx) nqaim thaum lub sij hawm kev tshoov siab, ua rau muaj kev txhawb zog siab.
Nyob ntawm cov leeg mob, peb pom cov nram qab no hom laryngeal paralysis hauv dev:
- Yog tias tsuas yog cov leeg nqaij dorsal cricoarytenoid ntawm ib sab ntawm lub larynx raug cuam tshuam (unilateral), peb hais txog laryngeal hemiplegia.
- Yog cov leeg ntawm ob sab ntawm lub larynx raug cuam tshuam (ob sab) peb hais txog ua kom tuag tes tuag taw.
Nws yuav tsum tau muab sau tseg tias laryngeal tuag tes tuag taw yog ib qho ntawm cov kev hloov pauv uas tuaj yeem ua ib feem ntawm tus mob brachycephalic, muaj nyob hauv 30% ntawm cov dev uas muaj tus mob no.
Symptoms of laryngeal paralysis in dogs
Cov tsos mob tshwm sim tuaj yeem pom hauv cov dev uas muaj kab mob tuag tes tuag taw yog:
- Laryngeal stridor: Ua pa txawv txav uas tshwm sim thaum kev tshoov siab. Raws li lub rima glottis nqaim, tsis kam mus rau txoj kev ntawm huab cua nce thiab turbulence yog generated, uas ua rau laryngeal stridor.
- Kev tsis haum tshuaj: qee zaum, kev sib txuam yuav tshwm sim.
- Dysphagia: nqos nyuaj. Kev hnoos yog tshwm sim thaum noj zaub mov lossis dej. Hauv qee cov tsiaj, kev mob ntsws ntsws tuaj yeem tshwm sim vim qhov kis ntawm cov zaub mov mus rau hauv lub ntsws.
- Kev hloov ntawm phonation: variations can be detected with respect to the lib barking, and can reach aphonia in some kis.
- Inspiratory dyspnea: ua pa nyuaj siab uas cuam tshuam rau theem inspiratory xwb.
- Tachypnea: ua pa ntau ntxiv.
- Cyanosis: bluish discoloration ntawm cov mucous daim nyias nyias vim tsis txaus oxygenation ntawm cov ntshav.
Cov tsos mob tshwm sim feem ntau yog laryngeal stridor (tam sim no hauv 97% ntawm cov neeg mob), ua raws li kev tawm dag zog (87%), dysphagia (41%) thiab phonation variation (39%).
Nws yuav tsum raug sau tseg tias cov tsos mob tuaj yeem ua rau hnyav dua los ntawm kev tawm dag zog lub cev, muaj kev ntxhov siab lossis ib puag ncig uas muaj qhov kub thiab txias.
Ua rau laryngeal paralysis hauv dev
Laryngeal paralysis tuaj yeem muaj ob hom:
- Congenital: thaum dev yug los nrog cov kab mob no.
- Acquired: thaum dev tsim cov kab mob no thoob plaws hauv lawv lub neej vim muaj ntau yam ua rau.
Tshuaj nyob rau hauv cov tsiaj xws li Siberian Husky, Rottweiler, Cattle Dog, Bull Terrier, thiab Dalmatian. Qee qhov xwm txheej, qhov muaj nyob ntawm autosomal dominant gene tau pom tias yog lub luag haujlwm rau cov cuab yeej cuab tam ntawm tus kab mob no.
Dog uas congenital laryngeal tuag tes tuag taw tam sim no hloov pauv vim yug, txawm tias cov cim qhia txog nws feem ntau tsis tshwm sim txog thaum lawv muaj 5 xyoos - 8 hli.
Acquired laryngeal paralysis
Pears in breeds like the Labrador Retriever, the Golden Retriever, the Saint Bernard or the Irish Setter. Nws tshwm sim ntau dua li qhov tshwm sim ntawm tus kab mob.
The uas tuaj yeem ua rau mob laryngeal tuag tes tuag taw hauv dev muaj ntau yam:
- Traumatisms (tom, qhov txhab, lub cev txawv teb chaws, kev phais) cuam tshuam rau cov hlab ntsha rov qab.
- Recurrent laryngeal nerve compression vim yog cov thyroid neoplasms, masses los yog abscesses in the neck or mediastinum.
- Hypothyroidism
- Polymyositis los yog myasthenia gravis.
- polyneuropathies ntawm metabolic, tshuaj lom los yog kis kab mob.
Txawm li cas los xij, nws yuav tsum tau coj mus rau hauv tus account tias feem ntau qhov ua rau ua rau tuag tes tuag taw tsis paub, tab sis feem ntau nws yog kab mob idiopathic, uas yog, tsis paub keeb kwm.
Diagnosis of laryngeal paralysis in dogs
Kev kuaj mob laryngeal paralysis hauv dev yuav tsum ua raws li cov ntsiab lus hauv qab no:
- , ua tib zoo saib xyuas cov paj hlwb kom ntsuam xyuas qhov muaj peev xwm myopathies lossis neuropathies. Kev kuaj mob paj hlwb yuav saib xyuas cov tsos mob xws li qaug zog lossis paresis, txo qis tus txha caj qaum, lossis cov leeg nqaij atrophy.
- Laryngoscopy (endoscopy ntawm theem ntawm lub larynx) kom pom tias thaum lub sij hawm kev tshoov siab qhib (abduction) ntawm pob txha mos tsis tshwm sim arytenoids. ntawm lub larynx. Tsis tas li ntawd, qhov tsis muaj suab nrov hauv lub suab thiab kev hloov pauv ntawm cov ntaub so ntswg uas nyob ib sab, tuaj yeem pom muaj edema thiab erythema. Laryngoscopy yuav tsum tau ua nyob rau hauv lub teeb sedation, vim hais tias, nyob rau hauv cov ntaub ntawv ntawm sib sib zog nqus sedation, lub reflexes ntawm lub caj pas yuav raug muab tshem tawm thiab ib tug cuav zoo yuav raug kuaj.
- Chest x-rays txhawm rau tshuaj xyuas lwm cov leeg nqaij txawv txav (xws li megaesophagus), mediastinal lossis intrathoracic masses, thiab aspiration pneumonia.
- ntshav kuaj nrog cov thyroid profile: Nws yog ib qho tseem ceeb kom txiav txim siab tias qhov ua rau tuag tes tuag taw yog hypothyroidism, vim nyob rau hauv cov xwm txheej no Kev Kho Mob tsis thim rov qab tus tuag tes tuag taw. Tsis tas li ntawd, kev kuaj mob tshwj xeeb tuaj yeem ua kom pom cov kab mob neuromuscular lossis myasthenia gravis.
Nws yog ib qho tseem ceeb kom paub tias kev tuav cov dev no hauv tsev kho tsiaj yuav tsum ceev faj tshwj xeeb, vim tias muaj kev ntxhov siab tuaj yeem ua rau muaj teeb meem cyanotic.
Tshuaj kho mob laryngeal paralysis in dogs
unilateral hemiplegia lossis tuag tes tuag taw feem ntau tsis kho, vim lawv feem ntau tsis cuam tshuam lub neej ntawm tus tsiaj. Txawm li cas los xij, nyob rau hauv rooj plaub ntawm ua tiav lossis ob tog tuag tes tuag taw, kev kho mob phais yuav tsum tau mus rau, vim cov tsiaj feem ntau muaj qhov ua tsis taus pa nruab nrab mus rau qhov ua tsis taus pa uas ua rau lawv lub neej zoo thiab kev noj qab nyob zoo.
Tam sim no, muaj ntau yam kev phais los kho laryngeal paralysis hauv dev. Nov yog peb qhov tseem ceeb tshaj plaws:
- Ib sab lossis ob sab lateralization ntawm pob txha arytenoid lossis "kiv rov qab".
- Ventriculo-cordectomy.
- Partial laryngectomy.
Txhua leej txhua tus yog npaj los (laryngeal open) pab txhawb nqa cov suab nkauj kho siab. Qhov qhib yuav tsum txaus kom txaus siab rau kev tso pa tawm, tab sis tsis dhau, vim nws tuaj yeem ua rau muaj kev pheej hmoo ntawm kev mob ntsws. Yog li ntawd, cov txheej txheem phais mob hnyav dua yuav tsum tau txiav tawm. Tam sim no, cov txheej txheem ntawm kev xaiv yog unilateral lateralization ntawm cov pob txha mos arytenoid siv qis-tension sutures. Ob qho tib si ventriculocordectomy thiab ib nrab laryngectomy ua rau cov txiaj ntsig tsis sib xws nrog tus nqi siab ntawm cov teeb meem, ua rau lawv tsis pom zoo cov tswv yim.
Postoperative care
Tom qab kev phais laryngeal paralysis, yuav tsum tau saib xyuas hauv qab no:
- Nws yog ib qho tseem ceeb kom ua tiav tshuaj loog kho kom zoo kom tsis txhob muaj kev ntxhov siab ntawm tus neeg mob. Tsis tas li ntawd, nyob rau lub sijhawm tom qab phais tas li nws yog qhov tseem ceeb los lav qhov tseeb oxygenation ntawm tus neeg mob.
- Tom qab 24 teev, dej me me yuav tsum muab rau tus tsiaj. Yog tias tus neeg mob ua siab ntev, noj ntub dej Tom qab ob lub lis piam, cov zaub mov qhuav tuaj yeem muab tau. Yog hais tias cov zaub mov qhuav tsis zam (hnoo tshwm sim, dysphagia, thiab lwm yam), cov khoom noj uas ntub dej yuav muab khaws cia rau lwm ob lub lis piam. Yog tias koj ua raws li kev noj zaub mov hauv tsev, nws yuav yog ib qho tseem ceeb uas yuav tsum tau muab nws kom zoo li qhov ua tau, thiab xaiv cov zaub mov uas yooj yim digestible.
- qoj ib ce yuav tsum tau txwv 3 lub lis piam, txawm hais tias kev txhim kho ntawm kev ua pa tsis ua haujlwm feem ntau yog tam sim.
- Thaum taug kev nws yog qhov zoo dua los siv harnesses es tsis txhob ntawm dab tshos.
Postoperative Complications
Nyob rau lub sij hawm postoperative ntawm laryngeal tuag tes tuag taw kev phais nyob rau hauv dev, nws yog ib qho tseem ceeb uas yuav tau mus koom rau cov tsos ntawm tej teeb meem, vim hais tias lawv tshwm sim nyob rau hauv yuav luag 35% ntawm cov neeg mob. Cov teeb meem tseem ceeb yog:
- Laryngeal edema vim yog kev siv ntau dhau. Txhawm rau zam qhov teeb meem no, kev kho corticosteroid feem ntau yog tsim nyob rau lub sijhawm tom qab phais.
- Cov teeb meem me: hnoos txuas ntxiv los yog stridor, tawm dag zog tsis haum, ntuav lossis seromas.
- Cov teeb meem loj: aspiration pneumonia (qhov kev pheej hmoo siab dua nyob rau thawj hnub tom qab ua haujlwm, txawm tias nws tseem nyob hauv lub neej, txij li qhov ntau dua qhib lub larynx tuaj yeem ua rau kev nkag mus ntawm cov zaub mov mus rau txoj hlab pa).
Txawm hais tias muaj teeb meem tom qab phais mob heev, feem ntau tsis mob hnyav thiab qhov kev tshwm sim luv luv thiab nruab nrab yog qhov zoo Qhov tseeb, yuav luag 90% ntawm cov neeg zov me nyuam ntawm cov dev uas muaj kab mob tuag tes tuag taw qhia pom tias muaj kev txhim kho hauv lawv tus khub tom qab kev phais.
Txawm li cas los xij, nws yuav tsum tau coj mus rau hauv tus account tias muaj lwm yam kab mob sib kis (neoplasms, megaesophagus, polyneuropathies, thiab lwm yam) ua rau cov neeg mob no tsis zoo.
Yuav ua li cas tiv thaiv laryngeal paralysis hauv dev?
Thaum muaj kab mob laryngeal tuag tes tuag taw, nws tau pom tias nyob rau hauv ib co breeds muaj ib tug autosomal dominant noob uas yog lub luag hauj lwm rau cov cuab yeej cuab tam ntawm tus kab mob no. Yog li ntawd, raws li kev tiv thaiv kev tiv thaiv, cov dev yug los nrog cov kab mob no yuav tsum tau tiv thaiv los ntawm kev yug me nyuam kom tsis txhob kis tus kab mob mus rau lawv cov xeeb ntxwv.
Txawm li cas los xij, tiv thaiv kom tsis txhob kis tus kab mob laryngeal tuag tes tuag taw nyuaj duaNtawm ib sab, vim muaj ntau yam ua rau nws tsim (neoplasms, polyneuropathies, polymyositis) tsis tuaj yeem tiv thaiv thiab, ntawm qhov tod tes, vim tias feem ntau cov kab mob yog idiopathic, uas yog, nws muaj keeb kwm tsis paub.
