The collapsing trachea…

Vet student in surgery

Most mammals, birds and reptiles rely on oxygen passing into their lungs to survive, with most of them doing so via a tube from the mouth to the lungs called a trachea. The size of this is normally relative to the species to allow for the exchange of air to take place into the lungs.

Now there are several differences between species in how this works with different areas that problems can occur. However today it was a dog, and its trachea instead of being round was pretty much a flat rectangle. Breathing was such a problem that this dog was a candidate for surgical intervention to make breathing easier. There are several options for this type of surgery – best outcome is usually using a wire stent deployed inside the trachea however this is relatively expensive especially for Slovakia. The other option is to try and use an external support around the outside of the trachea – this is what we did.

Once in surgery we opened the neck of the dog. This is one of the most complicated parts of the body considering the size and the number of structures within this area. There are glands, nerves, and blood vessels that pass in this area which if damaged can cause major problems. This is an area that I have not seen much surgery in so I was excited to be assisting today.

Separating the muscles that lay above the trachea we get our first look at it. Instead of the circular tube that would normally be seen the trachea was similar to fat ribbon passing along the neck. This was over more of the length of the trachea than I expected as generally collapse occurs over the thoracic inlet. Our plan was to use a syringe case to provide a circular structure around the trachea and so restore its normal shape and size of the internal opening to allow easier air flow.

We prepared the syringe to fit around the tracheal rings so we could attach it to by cutting it into short sections and then splitting and shaping the ends to avoid causing trauma. We separated down the length of the trachea so that we could fit these sections around. Something that really surprised me was the size of the laryngeal recurrens nerve – the one responsible for voice.

We applied the prepared supporting rings around the trachea, and sutured the trachea into these at key points to provide a frame for the shape of the trachea. For a syringe that costs maybe 25p the fact that it can be used in such a way is very surprising. Reading around the surgery however there are some big potential complications which makes the internal stent a more attractive option if the funds are available.

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