Chapter 99 Nasal Planum, Nasal Cavity and Sinuses

Question 1

Name the three nasal cartilages and two ligaments

Answer 1

Dorsal lateral cartilage

Ventral lateral cartilage

Accessory cartilage

Single dorsal nasal ligament, paired lateral nasal ligaments

Question 2

Name three muscles responsibel to opening of the nares

Which nerve innervates them?

Answer 2

• Levator nasolabialis*
• Orbicularis oris (branch of this muscle)*
• Levator labii maxillaries*

Innervated by facial nerve

Question 3

Name the four air passages/meatuses

Answer 3

Dorsal, middle, ventral , common

Question 4

What is the alar fold?

Answer 4

Bulbous extension of ventral nasal chonchae

(that fuses with wing of nostril)

Question 5

Name the three paranasal sinuses

Answer 5

Frontal, sphenoidal and maxiallary recess.

N.B sphenoidal not considered a sinus in dog as completely occupied by endoturbinate IV

Question 6

In dogs the frontal sinuses are divided into three compartments. Name them. What is the name of the drainiange passage?

Answer 6

Rostral (b), medial and lateral (d)

Nasofrontal opening

Question 7

What radiographic criterion had greatest predictive value for diagosis of nasal neoplasia?

What 2 radiographic signs were consistent with rhinitis?

Answer 7

Destruction of surrounding bones (lacrimal, palatine, maxillary)

Lack of frontal sinus lesion and lack of lucent foci

Question 8

What is the significance of septal deviation inn cats and dogs?

Answer 8

Significant in dogs, not in cats.

Question 9

What is a characteristic radiographic sign of fungal rhinitis?

Answer 9

Cavitary lesions/punctate bony lucency/chonchal lysis

Question 10

List 5 neoplastic and 5 non-neoplastic differentials for a nasal planum lesions

Answer 10

1. SCC
2. Fibrosarcoma
3. Lymphoma
4. Haemoangiosarcoma
5. Malignant melanoma
6. Arteritis
7. Discoid lupus erythematosus
8. Systemic lupus erythematosus
9. Pemphigus complex
10. Idiopathic depigmentation (vitiligo +- uveodermatological syndrome)

Question 11

What is the MST of dogs with nasal planum SCC treated with

1. Surgery alone
2. Radiation alone

And MST in cats treated (doesnt specify how…)

Answer 11

1. Surgery alone in dogs 12 week s
2. Radiation alone in dogs 26 weeks

Cats treated 12 months…

Surgery is treatment of choice +- adjuvant treatment

Question 12

What is the most common form of nasal neoplasia in cats, and in dogs

Answer 12

Cats = lymphoma

Dogs = adenocarcinoma

Radiation is treatment of choice for nasal tumours as surgery not shown to improve survival

Question 13

What is the most common nasal fungal infection in dogs?

And in cats?

Answer 13

• Aspergillus fumigatus* in dogs
• Cryptococcus neoformans* in cats

Question 14

List three broad treatment options for fungal rhinosinusitis

Answer 14

1. Trephination and infusion
2. Catheter infusion
3. Sinusotomy/rhinotomy

Question 15

What % of dogs with aspergillus treated with infusion catheters rsolves after

1. First instillation?
2. Overall (up to 4 infusions)

Answer 15

1. 65% resolved after single infusion
2. 87% cured after repeated infusion

Question 16

name unusual cause of sneezin g(+ associated with GDV risk)

Answer 16

Nasal mites (Pneumonyssoides caninum)

Question 17

Ciliary dyskinesia often seen as part of Kartagener syndrome, What 3 features = this syndrome?

Answer 17

1. Situs inversus
2. Rhinosinusitis
3. Bronchiectasis

Question 18

Risks of nasopharyngeal polyp removal by traction avulsion

Answer 18

1. Recurrence (64% of thise not treated with pred)
2. Horner’s syndrome
3. Vestibular signs

Question 19

How is choanal atresia classified? What clinical signs can be expected?

Answer 19

Partial vs Complete

and

Osseous vs Membranous

C/s: Difficulty suckling, chronic nasal discharge, dyspnoea

Question 20

List 3 treatment options for nasopharyngeal stenosis.

Answer 20

1. Open surgical resection
2. Endoscopic (or fluoro) guided baloon dilation
3. Stent (covered if completely closed, uncovered if open stricture). Complications = fracture, migration, oronasal fistula, tissue ingrowth, exaggerated swallowing hairball entrapment

Question 21

Label maxiallry, infraorbital, major palatine, dorsal nasal and lateral nasal arteries.

Answer 21

Question 22

List 4 rhinotomy approaches

Answer 22

1. Dorsal
2. Ventral
3. Lateral
4. Rostral/alveolar mucosal

Question 23

Why is maxillary artery compression an concern in cats?

Answer 23

Internal carotid artery regressed during embryoinc development. Cerebral perfusion is largely dependent of maxiallary artery (branch of external carotid). Cats also have greater supply from vertebral artery cf dogs.

Question 24

List 4 advantages of ventral rhinotomy over dorsal.

When should ventral not be performed (or with great care) and why?

Answer 24

1. Faster recovery
2. Lower risk of sc emphysema
3. Less post-op pain
4. More cosmetic closure

Avoid in growing animal as can affect muzzle growth