Banks et al: Influence of extreme brachycephalic conformation on perioperative complications associated with total ear canal ablation and lateral bulla osteotomy in 242 dogs (2010–2020)
Veterinary Surgery 5, 2023

🔍 Key Findings

Extreme brachycephalic breeds (EBBs) presented more acutely and at younger ages, most often with neurological signs compared to other breeds.
Preoperative signs such as facial nerve paresis, vestibular syndrome, and Horner’s syndrome were significantly more common in EBBs.
EBBs showed more severe imaging findings, including higher rates of otitis interna (46.3% vs. 8.5%) and brainstem changes (17.5% vs. 3%).
Intraoperative complications were more frequent in EBBs (11.1% vs. 5.3%), but this difference did not reach statistical significance (p = .078).
Perioperative complication rates did not differ significantly between EBBs and other breeds (23.5% vs. 29.3%).
Surgical time was significantly longer in EBBs (median 115 vs. 95 minutes; p = .011).
MRI or combined CT/MRI were more frequently used in EBBs, likely due to the higher prevalence of neurological signs.
Despite anatomical challenges, complication rates in EBBs were comparable, supporting TECA-LBO safety in these breeds.

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Banks et al: Influence of extreme brachycephalic conformation on perioperative complications associated with total ear canal ablation and lateral bulla osteotomy in 242 dogs (2010–2020)
Veterinary Surgery 5, 2023

🔍 Key Findings

Extreme brachycephalic breeds (EBBs) presented more acutely and at younger ages, most often with neurological signs compared to other breeds.
Preoperative signs such as facial nerve paresis, vestibular syndrome, and Horner’s syndrome were significantly more common in EBBs.
EBBs showed more severe imaging findings, including higher rates of otitis interna (46.3% vs. 8.5%) and brainstem changes (17.5% vs. 3%).
Intraoperative complications were more frequent in EBBs (11.1% vs. 5.3%), but this difference did not reach statistical significance (p = .078).
Perioperative complication rates did not differ significantly between EBBs and other breeds (23.5% vs. 29.3%).
Surgical time was significantly longer in EBBs (median 115 vs. 95 minutes; p = .011).
MRI or combined CT/MRI were more frequently used in EBBs, likely due to the higher prevalence of neurological signs.
Despite anatomical challenges, complication rates in EBBs were comparable, supporting TECA-LBO safety in these breeds.

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Multiple Choice Questions on this study

In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, how did the surgical time compare between EBBs and other breeds?

A. No significant difference

B. EBBs had shorter times

C. EBBs had significantly longer times

D. OBs had significantly longer times

E. Only staged surgeries were longer in EBBs

Answer: EBBs had significantly longer times

Explanation: Median surgical time was significantly longer in EBBs (115 min) than in OBs (95 min) (p = .011).

In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, what was the most common intraoperative complication observed?

A. Dural tear

B. Hypoglossal nerve damage

C. Laceration of parotid gland

D. Severe hemorrhage

E. Facial nerve transection

Answer: Severe hemorrhage

Explanation: Severe hemorrhage was the most common intraoperative complication, seen in 76.2% of those with intra-op events.

In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, which neurologic sign was most significantly more common in extreme brachycephalic breeds (EBBs) preoperatively?

A. Seizures

B. Facial nerve paresis

C. Ataxia

D. Hypoglossal nerve deficit

E. Trigeminal nerve paralysis

Answer: Facial nerve paresis

Explanation: Facial nerve paresis occurred in 28.4% of EBBs compared to only 5.3% in other breeds (p = .001).

In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, which diagnostic imaging findings were significantly more common in EBBs?

A. Middle ear effusion and canal mineralization

B. Brainstem changes and otitis interna

C. Unilateral changes and para-aural cysts

D. Stenotic auditory tubes only

E. Vertical canal rupture and bone cysts

Answer: Brainstem changes and otitis interna

Explanation: Otitis interna (46.3% vs. 8.5%) and brainstem changes (17.5% vs. 3%) were significantly more common in EBBs.

In Banks 2023 et al., on TECA-LBO in brachycephalic dogs, what was the overall perioperative complication rate and how did it compare between groups?

A. 18.5%; significantly higher in EBBs

B. 27.8%; higher in EBBs but not significant

C. 30.2%; significantly higher in OBs

D. 21.3%; lower in EBBs but significant

E. 33.1%; equal between groups

Answer: 27.8%; higher in EBBs but not significant

Explanation: Overall perioperative complications occurred in 27.8% of surgeries; the difference between EBBs (23.5%) and OBs (29.3%) was not statistically significant.

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