Angle the laser in a medial to lateral direction, which keeps the laser from affecting tissue outside the nostril, preventing visible depigmentation. Set the laser at 4 to 5 watts (W) on the continuous cutting setting for best results. Approach: When performing laser ablation, the medioventral aspect of the dorsolateral nasal cartilage is removed ( Figure 7).To ensure that all sponges are removed postoperatively, it is imperative to (1) either count the number of gauze sponges used or (2) clamp them with a hemostat before placing them in the caudal oral cavity. Additional Notes: During the procedure, inflate the endotracheal cuff and place gauze sponges in the back of the oropharynx to prevent blood from draining through the nasopharynx into the larynx.Leave ligatures in place for 10 to 14 days. It is unnecessary to suture the incision edge inside the nostril. A cotton-tipped applicator soaked in epinephrine and placed in the nostril also helps control hemorrhage.Use absorbable, monofilament suture material, such as 4-0 PDS (), in a simple interrupted pattern, to effectively widen the nares ( Figure 6). Closure: When apposing the 2 cut edges, suture the most ventral aspect of the incision first, which aids in hemostasis, leading to better visualization of the surgical field.
By performing the lateral wedge, more of the rostral alar fold is spared, allowing a larger, deeper incision and easier suturing. This approach differs from described techniques, which remove a wedge of rostral alar cartilage, leaving only a small amount of tissue rostrally on the nares. Approach: In typical brachycephalic dog breeds, we prefer to remove a wedge from the lateral aspect of the alar fold with a #11 surgical blade ( Figure 5).In these cases, we find that the best results are achieved by performing a rhinoplasty via laser ablation ( Table 4). In Persian cats and certain small brachycephalic breeds, wedge resection is not feasible due to the nares’ small size. Makes it hard to create a straight line while maintaining tension on the tissue being removed, leaving scarred, depigmented, and/or uneven tissue behind.Tends to char the edges of the incision, causing the superficial layer of the nose to slough and leaving a noticeable depigmented area.
In commonly affected brachycephalic breeds where the wedge resection technique is feasible, it is preferred over laser ablation because a laser: Stenotic nares are easily corrected using a wedge resection technique or laser ablation. Abnormalities should be corrected in the following order:ĬORRECTIVE SURGICAL TECHNIQUES Stenotic Nares
0 kommentar(er)
