small animal med- nasopharyngeal diseases

what is the nasopharynx?

cavity caudal to the choana and dorsal to the soft and hard palate

what are the most common nasopharyngeal diseases?

-tumors (esp in older cats)

-polyps (young cats <2yrs)

-stenosis

what is nasopharyngeal neoplasia usually an extension of?

nasal tumors

which cats is retropharyngeal lymphoma seen mostly in?

adult to older cats with stertorous breathing

what will be seen on rhinoscopy in cats with retropharyngeal lymphoma?

follicular hyperplasia in retropharyngeal area

how are nasopharyngeal tumors diagnosed?

biopsy and histopath

which age of cats commonly get nasopharyngeal polyps?

young cats (avg age: 1.5 yrs)

maine coons have higher risk

what are nasopharyngeal polyps?

pedunculated neoplastic growths

originate in the epithelium of tympanic bulla or auditive tromp

what are clinical signs of nasopharyngeal polyps?

-nasal discharge

-stertorous breathing

-sneezes

-reverse sneezing

-otitis with aural polyps

what is the prognosis of nasopharyngeal polyps?

favorable w/ mechanical removal

what is the recurrence rate of nasopharyngeal polyps?

-with traction only: 30-50%

-more common when middle ear is involved

-up to 4 yrs post removal

what are feline mesenchymal nasal hamartomas?

polypoid-like benign growth of nasal turbinates

how are mesenchymal nasal hamartomas different from polyps?

hamartomas arise from the native tissue of the nasal cavity

polyps start on the auditory tube or tympanic cavity

which age of cats get mesenchymal nasal hamartomas?

young cats, no breed predisposition

what are clinical signs of feline mesenchymal nasal hamartomas?

-progressive stertorous breathing

-sneezing and open-mouth breathing

-serous nasal discharge and epistaxis

what are clinical signs of severe cases of feline hamartomas?

sinonasal deformation, mass protruding thru nasal cavity

how are feline hamartomas diagnosed?

histopathology

what is the treatment for feline hamartomas?

-spontaneous regression may occur

-some may respond to glucocorticoids

-mechanical removal is tx of choice (sx or endoscope)

what is nasopharyngeal stenosis?

pathologic narrowing inside the nasopharynx, can be congenital or acquired

what are causes of acquired nasopharyngeal stenosis?

-chronic rhinitis (most common acquired cause)

-aspiration rhinitis

-surgery

-trauma

-tumors/polyps

what is the most common cause of nasopharyngeal stenosis in dogs?

aspiration rhinitis after an anesthetic event

what is the most common cause of nasopharyngeal stenosis in cats?

chronic rhinitis

what is the common age of nasopharyngeal stenosis in dogs?

2.4 years old

airways are almost equally patent and imperforate

what is the common age of nasopharyngeal stenosis in cats?

2-4 years

majority (90%) have patent airways

what are clinical signs of nasopharyngeal stenosis?

-stertorous breathing

-dyspnea

-oral breathing

-nasal discharge

-gagging and repeated swallowing attempts

how is nasopharyngeal stenosis diagnosed?

CT or rhinoscopy

CT needed if placing stent

how are thin lesions (>5mm) of nasopharyngeal stenosis managed?

ballon dilation placed with fluoroscopy

usually place a removable stent for these cases (remove after a couple months)

what is the success rate after 1 balloon dilation in nasopharyngeal stenosis cases with lesions >5mm?

1 balloon dilation alone:

dogs: 30%

cats: 50%

what is the success rate of balloon dilation in animals w/ nasopharyngeal stenosis lesion <5mm?

50% success w/ single attempt

what is the management for thicker lesions/unsuccessful balloon dilation cases of nasopharyngeal stenosis?

-balloon expandable metallic stent

-self expanding metallic stent

-covered metallic stents

-removable metallic stents

what is the prognosis for nasopharyngeal stenosis?

good, especially if benign cause

what are complications of nasopharyngeal stenosis?

complications usually arise if tumor present:

-tissue in-growth

-chronic infections

-oronasal fistula