Stenotic Nares Laser Surgery FAQ

Stenotic nares in a brachycephalic dog (left) compared to the open nostrils of a mesaticephalic dog (right).

Dog and cat brachycephalic breeds may have difficulty breathing through their nose. This may be due to stenotic nares, meaning narrow nostrils.^[1] This can be corrected as an outpatient procedure performed with an Aesculight carbon dioxide (CO₂) laser.

Brachycephalic Obstructive Airway Syndrome is a genetic disorder that compromises the upper airway most commonly in flat-faced/short-headed (brachycephalic) dog and cat breeds.^[2] Upper airway abnormalities correlated with BOAS include stenotic nares, an elongated soft palate, laryngeal collapse, extended nasopharyngeal turbinates, and others. A dog or cat with BOAS could be affected by one or more of these abnormalities.^[3]

Dog Breeds Affected By Brachycephalic Airway Obstructive Syndrome and Stenotic Nares include:

• Affenpinscher
• American Staffordshire Terrier
• American Bulldog
• Boston Terrier
• Boxer
• Brussels Griffon
• Bulldog
• Bullmastiff
• Cane Corso
• Chihuahua (apple-headed)
• Dogue de Bordeaux
• English Mastiff
• French Bulldog
• Griffon Bruxellois
• Japanese Chin
• King Charles Spaniel
• Lhasa Apso
• Neapolitan Mastiff
• Newfoundland
• Olde English Bulldogge
• Pekingese
• Pug
• Rottweiler
• Shar Pei
• Shih Tzu
• Tibetan Spaniel
• Valley Bulldog

Cat Breeds Affected By Brachycephalic Airway Obstructive Syndrome and Stenotic Nares:

• British Shorthair
• Burmese
• Exotic Shorthair
• Himalayan cat
• Persian cat
• Scottish Fold

Brachycephalic dog and cat breeds are born with these airway deficiencies, so they cannot be prevented, only treated, during the animal’s lifetime. BOAS is caused by selective breeding over hundreds of years. A flatter faced dog or cat is often considered cuter and it is bred this way without consideration for the pets’ overall health. Because the face is flattened it often does not allow for a sufficient airway.

Selective breeding practices predispose brachycephalic dogs and cats to the potential extreme conditions of BOAS. These animals are dependent on their owners to provide surgical solutions to improve their quality of life.  Without laser surgery correction of this condition, these brachycephalic breed animals cannot avoid the associated breathing difficulties of BOAS.

Some signs of stenotic nares and BOAS for pet owners to look for include:^[4]

• Distressed breathing – panting and overworking to breathe even while at rest.
• Abnormal breathing noises – such as constant snorting or snoring sounds, awake and asleep
• Unwillingness or inability to exercise
• Overheating – an inability to control their body temperature
• Fainting – even after brief or light exercise

Some pet owners are unaware that these signs negatively affect their pet’s quality of life. They may think that these symptoms are normal or even cute and desirable.

Owners of brachycephalic cat and dog breeds are often unknowingly putting their pets’ health at risk and not seeking life-changing treatment because they consider their pets’ breathing difficulties to be ‘normal’ for the breed.^[4] The ability to breathe adequately directly affects the overall health of the pet. Not treating stenotic nares when it is present can lead to less exercise, obesity, a shorter lifespan, and a lower quality of life.

Stenotic nares Aesculight laser surgery. Photo courtesy of Daniel Core, DVM.

The Aesculight CO₂ Laser is used to excise tissue covering or obstructing the nostrils to allow for increased airflow, thereby reducing the effort needed to breathe.^[5]

Laser stenotic nares surgery before and after. Photo courtesy of Daniel Core, DVM.

Aesculight CO₂ Laser Stenotic Nares Method

The use of an Aesculight CO₂ laser to correct stenotic nares and to perform other soft-tissue orofacial procedures offers many benefits over conventional methods such as scalpels, scissors or electrosurgical units. Some of these advantages include:

• No Bleeding: CO₂ laser surgical repair of stenotic nares is bloodless, which gives veterinary surgeons a clearer view of the surgical area, allowing for the most precise surgery.
• No Sutures Required: When this procedure is performed with a CO₂ laser no suturing is required because the laser seals blood vessels and capillaries.
• Less Pain: The CO₂ laser seals nerve endings and lymphatics, resulting in less pain and swelling. Pets will experience more comfortable post-operative recovery compared to conventional surgical methods.
• Reduced risk of infection: The CO₂ laser efficiently kills bacteria as it cuts, producing a sterilizing effect.
• Better Aesthetic Results: Using a CO₂ laser brings an excellent aesthetic result. There is reduced scarring due to decreased activation of myofibroblasts at the wound margin in comparison with scalpel surgery.
• Quicker recovery time: Because CO₂ laser surgery has less pain and less swelling, it will often allow the patient a faster recovery after the surgery.

Conventional Stenotic Nares Surgical Method

Conventional methods to perform stenotic nares surgery use a scalpel, which makes the procedure more difficult and riskier due to hemorrhage.

Due to an obstructed view of the surgical site through bleeding caused by the scalpel, the veterinary surgeon must be especially careful when trying to achieve symmetry of the nostrils.^[5]

A scalpel procedure often requires three to four sutures on both nostrils.^[6]

Because it is a scalpel procedure it may leave scars.^[5]

Recovery from Aesculight CO₂ laser surgery is most often quicker and more comfortable than that of scalpel surgery.  There is minimal postoperative care required. The pet is usually discharged the same day as the surgery with immediately noticeable improved breathing. If the nostrils become overly dry an ointment may be applied.^[5]

Brachycephalic dog and cat breeds that have stenotic nares have it from birth. A good time to perform an Aesculight CO₂ laser stenotic nares correction is at a young age, such as during a routine spay or neuter procedure, without adding a significant increase in anesthesia time.^[5] Other BOAS abnormalities, such as an elongated soft palate and laryngeal collapse, could also be assessed and treated at this time.

Early surgical intervention of stenotic nares is best. Stenotic nares surgery can decrease the severity and even eliminate clinical BOAS.^[5] If left untreated stenotic nares can lead to severe health problems.

If you are looking for local veterinarians who perform Aesculight CO₂ laser surgery, please use our Locate a Veterinarian form.

Introduction to Brachycephalic Obstructive Airway Syndrome (BOAS) Research Group at the University of Cambridge.