# Complication rate and outcomes of laryngeal cuneiformectomy in dogs with advanced laryngeal collapse

## TL;DR

This study shows that adding cuneiformectomy to standard surgery for dogs with severe laryngeal collapse does not increase complications and improves breathing outcomes.

## Contribution

Demonstrates cuneiformectomy is a safe and effective addition to multilevel surgery for advanced laryngeal collapse in dogs with BOAS.

## Key findings

- Cuneiformectomy did not increase complication rates compared to standard surgery.
- Dogs with cuneiformectomy showed significant improvement in respiratory function.
- Lower body condition score was linked to higher postoperative complications.

## Abstract

To describe the complication rate and outcomes of dogs undergoing multilevel airway surgery for brachycephalic airway syndrome (BOAS) with and without the addition of uni‐ or bilateral cuneiformectomy.

Retrospective study.

A total of 180 dogs undergoing BOAS surgery: 94 dogs undergoing modified multilevel surgery (non‐PC); 86 additionally undergoing cuneiformectomy (PC).

Case records from the University of Cambridge and Animal Health Trust databases between 2014 and 2021 were analyzed including data on laryngeal collapse grade, respiratory functional grading scores, BOAS index, hospitalization length and complications.

Neither the incidence risk of overall (non‐PC = 19.4%, PC = 16.3%, p = .758), nor major (non‐PC = 7.4%, PC = 11.6%, p = .482) complications differed between non‐PC and PC dogs. Median hospitalization duration (non‐PC = 1 day, PC = 1 day) did not differ between the two groups (p = .743). Both BOAS grade (median reduction = 1, p < .0001) and BOAS index (median reduction = 28.5%, p < .0001) reduced in dogs that underwent cuneiformectomy. Lower BCS was associated with increased postoperative complications (odds ratio = 0.452, p = .004) when preoperative BOAS grade and gender were controlled.

Cuneiformectomy was not associated with a higher incidence risk of complications than multilevel BOAS surgery alone. Significant improvements in respiratory parameters were observed following cuneiformectomy in addition to multilevel airway surgery.

Cuneiformectomy represents a safe and effective adjunctive technique to manage higher grade laryngeal collapse in dogs with BOAS.