As a surgeon, one unfortunately sees many dogs with BOAS (brachycephalic obstructive airway syndrome). Of these, the vast majority (87 – 94% in various studies) present with a presumed elongated soft palate. However, it’s not uncommon that when we get a close-up view of the problem, we wonder if the palate is significantly thickened rather than necessarily particularly long. This is likely due to the strong turbulence in the air and the subsequent irritation that occurs.
A group of surgeons also noticed this and therefore developed a technique to address the problem as early as 2010 – “split staphylectomy”. The technique involves not just shortening the soft palate, but first splitting it down the middle and filleting out excess tissue between the mucosal layers. Then, a temporary holding suture is placed to keep the layers together, before shortening the palate to the desired length on each side of the split and suturing everything together – usually so that the new soft palate aligns with the back of the tonsillar pocket.
A study recently published in JSAP takes a closer look at this technique to investigate whether it leads to more complications than more traditionally used procedures, and the authors have also contacted owners to hear how satisfied they are with their animal’s function afterwards. The results include 75 dogs, of which a total of 8.3% developed complications, which is somewhat higher than in similar studies of other methods – but only 2.7% of them were classified as serious, which was somewhat better than for the other methods. A full 88% of the owners who responded believed that their dog had experienced a significant improvement in quality of life – and notably, 88% of the dogs were sent home the same day, without any need for further hospitalization or tracheostomy at any point. The latter procedure is known to prolong the recovery period and significantly increase the frequency of complications, so this must be considered an advantage.
Again, the study is unfortunately retrospective, so a prospective randomized study is needed to say with certainty whether one method is better than the other. For now, we can be aware of the method as a relatively safe alternative when we find a significantly thickened palate.
Here is a link to the study:
https://doi.org/10.1111/jsap.13485
