Enlarging Nasal Openings in Dogs

Enlarging the nasal openings is a surgical procedure used to correct stenotic nares (narrow nostrils) in brachycephalic dog breeds. Stenotic nares is a component of brachycephalic syndrome, an upper airway obstruction disorder seen in breeds like the Boston terrier, Pug or Bulldog. Stenotic nares results from a malformation of the alar folds that form the nostrils. The external nares is made up of three cartilages: The accessory cartilage, the ventral parietal cartilage, and the dorsal parietal cartilage. The alar folds are the fleshy, lateral borders of the nostrils that collapse inward upon respiration. In the case of stenotic nares, the alar folds collapse farther than needed, resulting in complete temporary closure of the nostril. 

The surgical procedure required to correct stenotic nares is performed by a veterinarian or veterinary otorhinolaryngology specialist, focusing on the removal of the excess tissue wedge from the alar fold.  

The dog will need to be fasting (no food or water) the night before surgery and the day of surgery. Prior to anesthesia, the dog’s blood will often be tested to ensure his/her organs are functioning properly and signs of undiagnosed diseases are absent from the blood work. As some bleeding is always expected in a surgery, the veterinarian may perform a coagulation test or test to ensure the dog has enough clotting factors (platelets) in the blood. 

1. An IV catheter is placed 
2. A pre-anesthetic, pain medication, and antibiotic are injection to the dog. 
3. The dog will be feeling drowsy from the pre-anesthetic/sedative. 
4. The dog will be placed under general anaesthetic and intubated.
5. The dog is placed in ventral recumbency with the head facing the end of the operating table. 
6. The vet will inject a local anesthetic to the nasal tissues. 
7. The nose is scrubbed for surgery
8. The veterinarian will use a #15 blade scalpel to create angled incisions in the alar fold in the shape of a triangle. This incision pattern will be repeated to the adjacent nostril. 
9. Once the external wedge has been removed, the vet will work his/her way inside the nostril, removing pie-shaped sections of cartilage from the alar fold. 
10. Hemorrhaging will be controlled with direct pressure. 
11. A 4-0 Monocryl suture will be placed in the alar fold. The stitches with run from the outside to the inside to close the opening in the skin. 
12. The process with be completed on both nostrils, achieving symmetrical nostril openings. 
13. Sponges will be placed on the nose to keep it moist and clean. 
14. The dog will be allowed to rest in a recovery kennel. 

Enlarging nasal openings in dogs is a highly effective surgical procedure used as a multi-pronged treated to alleviate brachycephalic airway syndrome. Opening the nostrils helps more oxygen flow and reduces reparatory effort. The procedure itself is relatively simple to perform, requiring very little anesthesia with minimal complications. The majority of patients show improvements immediately following surgery. 

Dogs that have undergone a stenotic nares correction surgery will be released from the hospital the day of the surgery. Some canines appear drowsy and inactive, whereas other dogs return to normal behavior quickly. In either case, the dog must be confined and restricted of physical activity to prevent the sutures from coming loose. An Elizabethan collar should be sent home with the dog to prevent rubbing of the incision site. Pain medications, paired with a broad spectrum antibiotic will be administered as directed by the veterinarian. 

The cost of an enlarging nasal opening surgery in dogs will run between $200 and $1,000. The price of your dog’s correctional procedure depends on the severity of the malformation and the procedure used. Some veterinarians will use a laser instead of a scalpel blade, which will raise the price tag. 

The use of anesthesia is always a concern for dog owners, but due to the fact that the dog is under constant monitoring, anesthetic risks are minimal. Your veterinarian will take special considerations as enlarging nasal openings in dogs is a surgery that requires careful monitoring. Additionally, if your dog’s respiratory obstruction is due to other malformations associated with brachycephalic airway syndrome, such as an elongated soft palate, correcting the stenotic nares will not completely fix the problem. 

Stenotic nares and brachycephalic syndrome are congenital issues related to the facial structure of brachycephalic dogs. Responsible breeding, whereby we do not breed those dogs with stenotic nares, is the way forward. 

Your vet may have recommendations for easing your dog’s breathing prior to surgery, such as minimizing exposure to hot and humid weather, maintaining a healthy weight, and using a harness, rather than a collar, for attaching a lead.