Folded-flap palatoplasty is not superior to cut-and-sew staphylectomy for the treatment of brachycephalic obstructive airway syndrome in English Bulldogs.

Objective: To determine whether folded-flap palatoplasty (FFP) results in improved respiratory outcomes compared to standard staphylectomy (SS).

Methods: English Bulldogs were randomized to receive FFP or SS in a parallel, equal-allocation, prospective study design at a single institution. Exercise-tolerance testing (ETT), arterial blood gas, head CT, and an owner survey were completed preoperatively and at recheck (approx 30 days postoperatively). Soft palate (SP) length and thickness and pharyngeal air volume were measured on blinded CT images. Linear mixed models and Mann-Whitney U tests were performed.

Results: 16 dogs completed the study (FFP group, 8; SS group, 8) and 3 did not (excluded due to FFP dehiscence [2] and lack of recheck [1]). Median preoperative ETT grade was not different between groups (SS group, 1 [0 to 3]; FFP group, 1.5 [1 to 3]). Standard staphylectomy resulted in a greater reduction in SP length compared to FFP (P = .020; FFP, 5.79 ± 0.50 cm preoperatively, 4.86 ± 0.52 cm at recheck; SS, 6.13 ± 0.53 cm preoperatively, 4.57 ± 0.47 cm at recheck). No other variables differed between groups. At recheck, owners subjectively rated their dogs as improved (FFP group, 5; SS group, 8), unchanged (FFP group, 2), and not rated (FFP group, 1).

Conclusions: Folded-flap palatoplasty did not improve SP thickness, pharyngeal air volume, ETT, arterial blood gas values, or owner survey variables more than SS in these English Bulldogs. Standard staphylectomy resulted in a greater reduction in SP length than FFP.

Clinical Relevance: Standard staphylectomy or FFP can be performed in English Bulldogs. Standard staphylectomy may be preferable due to dehiscence potential with FFP.