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Surgery of the nose and nasopharynx
British Small Animal Veterinary Association , 46 (2018); https://doi.org/10.22233/9781910443347.4
/content/chapter/10.22233/9781910443347.chap4
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Surgery of the nose and nasopharynx

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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

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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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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) © 2018 British Small Animal Veterinary Association
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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)
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4.7
Rhinoscopic view from the left abnormal common meatus of the branched maxilloturbinates, obtained using a rigid endoscope. © 2018 British Small Animal Veterinary Association
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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The flap of bone is discarded.
The flap of bone is discarded. © 2018 British Small Animal Veterinary Association
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Image of The flap of bone is discarded.
The flap of bone is discarded. The flap of bone is discarded.
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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. © 2018 British Small Animal Veterinary Association
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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.
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Abnormal tissue is removed with the associated turbinates using a large curette.
Abnormal tissue is removed with the associated turbinates using a large curette. © 2018 British Small Animal Veterinary Association
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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.
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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. © 2018 British Small Animal Veterinary Association
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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.
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The periosteum is closed over the bony defect with simple interrupted sutures.
The periosteum is closed over the bony defect with simple interrupted sutures. © 2018 British Small Animal Veterinary Association
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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.
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Complete closure of the periosteum and partial closure of the subcutaneous tissue.
Complete closure of the periosteum and partial closure of the subcutaneous tissue. © 2018 British Small Animal Veterinary Association
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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.
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The skin is closed with simple interrupted sutures.
The skin is closed with simple interrupted sutures. © 2018 British Small Animal Veterinary Association
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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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