"Brachycephalic" means "short-headed" The French bulldog, bulldog pug, pekingese, shih tzu, boxer, Japanese chin and Boston dog are just a few examples of breeds with brachycephalic characteristics. One of the most distinct characteristics of these breeds is their small muzzle. This webinar covers the following aspects of the surgery procedure. - Components of the BOAS - Patient Position - Equipment - Protocol - Staphylectomy - Alaplasty - Laryngeal sacculectomy - Recovery

1. Know-how…
…BOAS surgery
Matteo Rossanese
DVM SPSA CertAVP MSc MRCVS

2. What we can address?
• Stenotic nares
• Elongated soft palate
• Everted laryngeal saccules

3. Patient position
• Sternal recumbency
• Tilted table

4. Equipment
• N° 11 blade
• Metzenbaum scissors
• Mosquito forceps
• Long thumb forceps
• Needle holder
• Urinary catheter
• Suction
• An assistant would be helpful

5. Protocol
• Omeprazole 1mg/kg IV q12h
• Metoclopramide CRI 1mg/kg/day
• Dexamethasone 0.2-0.5mg/kg IV
• Preoxygenation
• Quick intubation
• Cuffed endotracheal tube

6. Staphylectomy
• Middle to caudal border
of palatine tonsils
• Minimal traction on
palate or tongue

7. Staphylectomy

8. Staphylectomy

9. Staphylectomy • 3-0 or 4-0 monofilament
rapidly absorbable
• Appose oropharyngeal
and nasopharyngeal
epithelial surfaces

10. Staphylectomy

11. Staphylectomy

12. Staphylectomy
Findji , L. & Dupré, G. (2008) Folded flap
palatoplasty for treatment of elongated soft
palates in 55 dogs. Wiener Tierärztliche
Monatsschrift 95, 56-63

13. Alaplasty

14. Alaplasty
• Wedge excision
• Vertical
• Horizontal
• Lateral
• Made with:
• No 11 blade
• No 15 blade
• Punch

15. Alaplasty

16. Alaplasty

17. Alaplasty
• 3-0 or 4-0 monofilament rapidly absorbable
• Align the rostroventral margins

18. Alaplasty

19. Laryngeal sacculectomy

20. Laryngeal sacculectomy

21. Laryngeal sacculectomy

22. Ready for recovery
• Suction blood or accumulation of mucous/fluids
• No ongoing bleeding
• Calm and slow recovery
• Oxygen near by
• Ongoing monitoring
• Intubation kit
• Ready for temporary tracheostomy
• Withhold the food

23. To go home
• The day after
• Omeprazole 1mg/kg PO q12h for 14 days
• Metoclopramide 0.5mg/kg PO q8-12h for 14 days
• Paracetamol 10mg/kg PO q8-12h for 5 days
• Harness
• Weight control
• Exercise restriction
• Soft food (handfed with meatballs)

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