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Writer's pictureAbbie Tipler

Brachycephalic Airway Surgery - as young as possible


Looking at results from a recent 2021 paper (Carabalona 2022 JAVMA), the only factor that was predictive for risk of death post brachycephalic airway surgery, was age. The risk of death increased by 29.8% as dogs age increased by 1 year. Sex, body weight, breed, preoperative respiratory and digestive system signs and presence and grade of laryngeal collapse did not significantly impact the risk of death in this retrospective study. ⁠

Take-home - BOAS surgery should be performed as early in life as possible. This is supported by other literature. ⁠

Picture - I CT all my airway dogs pre-operatively. My primary surgical supervisor and legend brachycephalic surgeon Adjunct Professor Philip Moses taught me that this is the best way to fully assess their co-morbidities (other conditions), and unfortunately there are often many. It also allows assessment of nasal turbinates, and you can obtain a base-line CT of their spine for comparison (when they come back later for spinal issues...as unfortunately they often do). There has been some debate about whether these dogs need a CT scan - my view is that they can go through the scanner in around 90 seconds, there is no repositioning required (versus radiographs), and you get a maximal amount of information on upper airways, skull (including middle ear), thorax (including aspiration), abdomen (not 100% sensitive for hiatal hernia but I always check for this) and spine. ⁠

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