Laryngeal Paralysis

Laryngeal Paralysis is a cause respiratory difficulty in (usually) older dogs due to loss of nerve function to a key muscle in their throat (specifically their larynx or voice box). The CAD (cricoarytenoid dorsalis) muscle is responsible for opening the voice box for inhalation. When this muscle becomes paralyzed, the voice box stays partially closed and creates an obstruction like breathing through a straw. This is especially stressful and dangerous during times of exercise, stress, or extreme heat, and can quickly become life threatening.

Because the cause of laryngeal paralysis is unknown (idiopathic) in the majority of cases, surgical treatment is aimed at reestablishing a functional airway. Arytenoid Lateralization or Laryngeal “Tie Back” is the treatment of choice. Through an incision on the side of the neck, cartilage attachments are pulled together and tied permanently to mimic the action of a normally contracting CAD muscle. This pulls half of the voice box open to allow easy page of air and therefore resolution of the respiratory difficulty.

Due to one side of the voice box always being in the “open” position, aspiration of food and water is a potential complication. Most only have mild coughing associated with drinking water, but all patients are warned about the risk of aspiration pneumonia and potential signs to monitor for (loss of appetite, coughing, lethargy). Because of the risks with one sided tiebacks, both sides are never tied back.

The success rate with Laryngeal Tie Back is 8590%, with most dogs returning to their normal lives within 6 to 8 weeks of surgery. Laryngeal Paralysis is often of unknown causes (idiopathic), however, in some pets, it may be the first of other neurologic conditions yet to manifest. Further monitoring of your pet’s condition may be recommended, including evaluation by a neurologist.