Pharyngotomy in Dogs

When surgical procedures need to be performed in the maxillofacial area to address fractured mandibles, tumors, or reconstruction in the oral cavity, an esophageal tube to maintain general anesthesia by gas can obstruct the surgical area and make the surgery difficult or impossible to perform. In order to maintain anesthesia through an endotracheal tube, and not via the oral cavity, a pharyngotomy can be performed, which is a surgical incision of the pharynx that allows the endotracheal tube to exit the pharynx incision and frees the oral cavity for orthopedic and other procedures to be successful. This procedure is performed while your dog is under general anesthetic with the use of an endotracheal tube placed in the traditional way, and after incision of the pharynx through the outside wall the tube can be repositioned to exit the pharynx wall. As mandibular fractures and reconstructions in the oral cavity are procedures that are frequently required in dogs, this procedure allows for better outcome of maxillofacial repairs by ensuring your veterinarian can access structures adequately to perform what are sometimes complex orthopedic surgeries in the face, neck and head.

Your dog will be sedated, an intravenous line setup, and an endotracheal tube inserted via the oral passage to maintain gaseous anesthesia. The area on the outside wall of the pharynx is shaved and cleaned antiseptically prior to incision of the pharyngeal wall of the piriform fossa caudal to the articulation between the stylohyoid and epihyoid bones. To perform this incision your veterinarian will place a finger into the pirifossa behind the base of the tongue and to the side of the hyoid apparatus which will reduce a bulge on the wall where the incision is to be made. The incision is made and forceps are inserted through the outside wall into the pharynx. The adapter is removed from the esophageal tube and the bulb on the tube deflated to allow the tube to be advanced into the pharynx passage. The endotracheal tube is then grabbed with the forceps and pulled out through the pharyngeal incision. The tube is then advanced into the appropriate position in the trachea. Once positioned correctly it is sutured in place to ensure it remains correctly positioned throughout the maxillofacial procedure. 

When other procedures are complete the tube is removed by the reverse process with the tube being advanced into the pharynx and pulled back into the oral cavity. The pharynx incision is sutured. General anesthesia is discontinued and your dog is put into recovery.

This procedure is very effective to allow access to maxillofacial structures while maintaining anesthesia through gas. This ensures the best outcome for the orthopedic procedure or lesion removal in the facial area while ensuring that the animal remains comfortable under general anesthetic. 

Recovery for pharyngotomy will be paired with recovery for the alternate surgical procedure performed necessitating the pharyngotomy. Specifically, ensure that the pharynx incision does not rupture or become infected and prevent your dog from scratching at the incision. Bandaging may be required to achieve this. Medications such as antibiotics and analgesics are routinely prescribed for surgical procedures accompanying pharyngotomy.

The cost of pharyngotomy in your dog will be a portion of the overall charges for medical treatment provided. Specifically, pharyngotomy costs range from $100 to $300, but total charges for the procedure will include anesthesia, the primary operation, and medication. Typical charges for surgeries including pharyngotomy can range from $500 to $3,000.

There is a risk of infection, hemorrhage, and complications related to anesthesia with all surgeries. Specifically to pharyngotomy, esophageal damage, nerve damage and vocal cord damage can occur if pharyngeal incision unintentionally interferes with these structures. 

Preventing incidents such as motor vehicle accidents and fights with other dogs or altercations with other animals such as livestock that may result in damage to maxillofacial structures will reduce the requirement for maxillofacial surgery requiring pharyngotomy. Also ensuring that your dog does not chew on sharp objects such as bones that can cause damage to their oral cavity will reduce oral cavity damage and will also prevent other disorders in the digestive tract that may cause severe disorder and require extensive medical intervention.