1887

Surgery of the nose and nasopharynx

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Abstract

This chapter covers investigation of nasal discharge including physical examination and diagnostics; the surgical techniques of rhinotomy and nasal planum resection and reconstruction; and management of the specific conditions nasal aspergillosis, chronic rhinitis/sinusitis in cats, nasal neoplasia, stenotic nares, nasal dermoid sinus, choanal atresia and nasopharyngeal stenosis, and nasopharyngeal polyps. : Dorsal rhinotomy.

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Figures

Image of 4.2
4.2 (a) An arrowhead lodged in the nasal cavity of a dog that caused signs of chronic mucopurulent rhinitis is removed during a dorsal rhinotomy. (b) Close-up of the arrowhead.
Image of 4.5
4.5 Intraoral dorsoventral radiographs of the nasal cavity. (a) Normal middle-aged dolichocephalic dog. (b) A 10-year-old Border Collie with a nasal carcinoma. (c) A 2-year-old Labrador Retriever with bilateral fungal rhinitis.
Image of 4.6
4.6 Computed tomographic (CT) images of the nasal cavity of a dog with nasal carcinoma: (a) at the level of the second premolar; (b) at the level of the cribriform plate. The left nasal cavity is filled with soft tissue, the tumour extends through the nasal septum and there is destruction of the palatine, maxillary, frontal and turbinate bones. Exophthalmos is evident. (Courtesy of C Lamb)
Image of 4.7
4.7 Rhinoscopic view from the left abnormal common meatus of the branched maxilloturbinates, obtained using a rigid endoscope.
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4.8 Lateral rhinotomy. (a) The most rostral aspect of the nasal planum is preserved by creating a U-shaped flap to access the most rostral part of the nasal vestibule. (b) A lateral rhinotomy incision is shown, which will allow for complete exposure of the nasal vestibule.
Image of 4.9
4.9 (a, b) Rostral maxillectomy with nasal planum resection was performed for an invasive squamous cell carcinoma. (c) Owners should be aware and accepting of their pet’s altered appearance prior to selecting this treatment option.
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4.10 Rhinoscopic view of nasal aspergillosis; atrophy of turbinates with severe inflammation of the mucosal lining of remnant turbinates is visible, with macroscopically identifiable fungal growth.
Image of 4.11
4.11 Placement of catheters for nasal and sinus infusion with clotrimazole. Endotracheal intubation with cuffing and packing the caudal pharyngeal area are mandatory to prevent aspiration of clotrimazole. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Image of 4.12
4.12 (a) The arrow points to a nasal pit in the nasal planum of this dog with nasal dermoid sinus. (b) A catheter has been placed in this dog’s nasal dermoid sinus to help identify the tract during excision.
Image of A midline incision is created over the nose through the skin and subcutis.
A midline incision is created over the nose through the skin and subcutis. A midline incision is created over the nose through the skin and subcutis.
Image of The incision is deepened to the level of the bone in the midline and the periosteum is elevated over the nasal bone of the side that requires exploration and turbinectomy.
The incision is deepened to the level of the bone in the midline and the periosteum is elevated over the nasal bone of the side that requires exploration and turbinectomy. The incision is deepened to the level of the bone in the midline and the periosteum is elevated over the nasal bone of the side that requires exploration and turbinectomy.
Image of A rectangular flap of bone is outlined with rongeurs prior to full-thickness resection.
A rectangular flap of bone is outlined with rongeurs prior to full-thickness resection. A rectangular flap of bone is outlined with rongeurs prior to full-thickness resection.
Image of The flap of bone is discarded.
The flap of bone is discarded. The flap of bone is discarded.
Image of Samples are taken from the nasal cavity for cytology, culture and sensitivity testing.
Samples are taken from the nasal cavity for cytology, culture and sensitivity testing. Samples are taken from the nasal cavity for cytology, culture and sensitivity testing.
Image of Abnormal tissue is removed with the associated turbinates using a large curette.
Abnormal tissue is removed with the associated turbinates using a large curette. Abnormal tissue is removed with the associated turbinates using a large curette.
Image of Bleeding associated with turbinectomy stops once all abnormal tissue and turbinates have been removed.
Bleeding associated with turbinectomy stops once all abnormal tissue and turbinates have been removed. Bleeding associated with turbinectomy stops once all abnormal tissue and turbinates have been removed.
Image of The periosteum is closed over the bony defect with simple interrupted sutures.
The periosteum is closed over the bony defect with simple interrupted sutures. The periosteum is closed over the bony defect with simple interrupted sutures.
Image of Complete closure of the periosteum and partial closure of the subcutaneous tissue.
Complete closure of the periosteum and partial closure of the subcutaneous tissue. Complete closure of the periosteum and partial closure of the subcutaneous tissue.
Image of The skin is closed with simple interrupted sutures.
The skin is closed with simple interrupted sutures. The skin is closed with simple interrupted sutures.

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