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Surgery of the Upper Airways, Thyroid, Larynx and Trachea > Nasal Disease: Surgical Approach to the Nasal Cavity > Flashcards

Nasal Disease: Surgical Approach to the Nasal Cavity Flashcards

1
Q

The most frequent tumour to affect the nasal planum is the

A

SCC

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2
Q

Are dogs or cats nasal planum tumour more likely to need surgery as more invasive on presentation?

A

Dogs

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3
Q

Where do nasal planum tumours often originate in dogs?

A

Nasal vestibule

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4
Q

How to perform diagnostic biopsies of nasal planum?

A
  • Scalpel slice
  • Punch
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5
Q

Normal met site of SCC of the nasal planum?

A

LN

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6
Q

The prognosis for tumours that have metastasised to the lymph node?

A

May be guarded

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7
Q

If a SCC has met to the LN, what other met check needed?

A

Thorax (xray vs ct)

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8
Q

Treatment options in SCC in cats (superficial) (3)

A
  • Photodynamic
  • Strontium
  • Curettage with cautery
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9
Q

Define deep nasal tumour?

A

> 5mm

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10
Q

Tx for deep nasal lesion?

A

Nasal planectomy

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11
Q

How to mark histo edges for the pathologist?

A

Indian ink

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12
Q

What blood test should be performed before nasal surgery?

A

Coagulopathy

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13
Q

Pre op planning with planectomies; what should be included? (3)

A
  • Blood profiles and BMBT
  • MRI scan unless very superficial lesion (most dogs require advanced imaging, cats are usually more superficial)
  • Lots of owner preparation (particularly if young children in the family).
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14
Q

For clean surgical margins of? is usually sufficient.

A

a 1 cm

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15
Q

Nasal planectomy; nerve blocks?

A

infra orbital

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16
Q

Surgical prep in cats for nasal planectomy:
Do you leave whiskers in place?

A

If poss

17
Q

Surgical prep in cats for nasal planectomy:
Surgically prep with what? (2)

A

The oral cavity prepped with a dilute povidone-iodine solution or aqueous chlorhexidine.

18
Q

Surgical prep in cats for nasal planectomy:
Position?

A

ventral recumbency with the mouth slightly opened using a mouth gag.

19
Q

Surgical prep in cats for nasal planectomy:
Surgical margins? What happens if not possible?

A

1cm; if this isnt poss a 0.5 cm margin will often result in clean surgical margins.

20
Q

Surgical prep in cats for nasal planectomy:
For larger tumours, or those situated more ventrally, the nasal planectomy should be combined with

A

pre-maxillectomy.

21
Q

What should be left in place during a cat nasal planectomy to aid recontruction?

A

A small strip of skin is left in place at the rostral lip

22
Q

The lips are very vascular and haemostasis is provided by (4)

A

electrosurgery,
artery forceps
ligation
Ice cold saline soaked swabs

23
Q

In cases where only the nasal planum has been resected, how to reconstruct?

A

skin can be sutured to the maxilla using simple interrupted rolling sutures or a purse string suture.

24
Q

How to place an simple interrupted rolling suture?

A

anchoring the skin through holes made in the maxilla using K-wires

25
Q

Suture material for nasal planectomy?

A

absorbable suture of 2M or 1.5M monofilament suture such as polydiaxanone

26
Q

When the nasal planectomy has been combined with a premaxillectomy, what are used to close the defect?

A

unilateral or bilateral labial flaps

27
Q

When the nasal planectomy has been combined with a premaxillectomy; The labio-gingival borders are incised as necessary to permit tension free advancement, aiming for a palatobuccal recess of about

A

1cm

28
Q

When the nasal planectomy has been combined with a premaxillectomy,
What helps reduce a rostral nasal fistula?

A

Suturing the labial submucosa to the palatine bone using bone holes made with k-wires

29
Q

How many layer closure
Suturing the labial submucosa to the palatine bone using bone holes made with k-wires

What is involved?

A

A three-layer closure of palatine periosteum/bone tunnels to labial submucosa followed by oral mucosa medially and skin laterally is used.

30
Q

How to perform a lip flap in a dog?

A

remove the skin from one side and the mucosa from the other side bar the 1-2 cm distal mucocutaneous junction to create a terminal island of skin, labial mucosa and labial margin.

31
Q

Post nasal planectomy; feeding?

A

sloppy food and continue soft food for 4-6 weeks

32
Q

Other than possible feeding/tube what needs to be assisted in cats post planectomy?

A

Grooming

33
Q

How to remove sutures after planectomy?

A

sedate/GA

34
Q

How to prevent food debris post planectomy?

A

nasal aperture will initially need gentle cleaning with damp cotton buds or swabs to remove food debris

35
Q

Post op complications with nasal planectomy? (5)

A

Dehiscence

Nasal stenosis

Recurrence

Anorexia

Sloppy eating and retrieving ability will be affected

36
Q

The one-year survival rate after resection for nasal planum squamous cell carcinomas in cats is?

A

80% +

Surgery of the Upper Airways, Thyroid, Larynx and Trachea (10 decks)

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