Surgical Diseases of the Nasal Cavity

Question 1

what are the main differential diagnoses for canine nasal cavity disease?

Answer 1

foreign body
mycotic rhinitis (Aspergillosis)
nasal sinus neoplasia

Question 2

which biopsies can be collected for nasal disease?

Answer 2

paranasal/transnostral core biopsy
incisional biopsy
nasal flush

Question 3

what should you measure prior to performing a paranasal/transnostral core biopsy?

Answer 3

to medial canthus of eye
distance to cribriform plate

Question 4

in whom is a dorsal rhinotomy not well tolerated?

Answer 4

cats

Question 5

what is done in a dorsal rhinotomy?

Answer 5

remove rectangular piece of bone

Question 6

what is the most common cause of mycotic infection in dogs?

Answer 6

Aspergillus
also Penicillium

Question 7

why must the cribriform be intact for topical clotrimazole?

Answer 7

CNS irritant: may cause seizures

Question 8

what are the potential neoplasias?

Answer 8

carcinomas: 60-70%
sarcomas
rare: lymphoma

Question 9

are nasal tumors more common in cats or dogs?

Answer 9

dogs- much more

Question 10

what percentage of intranasal neoplasias are malignant?

Answer 10

> 90%

Question 11

what are the clinical signs with neoplasia?

Answer 11

epistaxis and/or mucopurulent discharge
facial deformity
ocular signs
rare: CNS signs

Question 12

what is the most rewarding way to biopsy an intranasal neoplasia?

Answer 12

transnostral core

Question 13

what is the mean survival time of radiation without surgery for nasal neoplasia?

Answer 13

12+ months

Question 14

what is the biggest problem with secondary cleft palate?

Answer 14

unable to suckle

Question 15

when should surgery for secondary cleft palate be performed?

Answer 15

4+ months of age
may need multiple surgeries

Question 16

what is a frequent cause of nasal discharge in cats?

Answer 16

virus

Question 17

what would clinical signs present for months without progression indicate?

Answer 17

structural or inflammatory

Question 18

what does a nasal foreign body cause?

Answer 18

unilateral
serosanguinous and then mucopurulent discharge (others usually mucopurulent)

Question 19

should you expect improvement with antibiotics regardless of disease causation in nasal?

Answer 19

yes

Question 20

is a nasal flush often unrewarding?

Answer 20

yes

Question 21

is hemorrhage expected with dorsal rhinotomy?

Answer 21

yes: moderate to severe

Question 22

what are the potential complications of a dorsal rhinotomy?

Answer 22

post-op hemorrhage
serosanguinous nasal discharge
subcutaneous emphysema

Question 23

what is frequently necessary for nasal foreign body?

Answer 23

surgical exploration

Question 24

what mycotic infection can be treated with oral antifungals?

Answer 24

Cryptococcus in cats

Question 25

what sign is specific to Aspergillosis in dogs?

Answer 25

depigmentation- ulceration around nares

Question 26

how can mycotic infection be diagnosed?

Answer 26

CT
frontal sinuscopy for fungal plaques
biopsy and histology: best

Question 27

what is the preferred method to treat mycotic infection?

Answer 27

topical clotrimazole
85% success rate first time
via trephine in frontal sinus

Question 28

when would a dorsal rhinotomy be indicated for mycotic infection?

Answer 28

non-responsive cases
remove all diseased
clotrimazole soaked sponges intra-op

Question 29

what is the most common intranasal tumor?

Answer 29

adenocarcinoma

Question 30

what are the most common intranasal neoplasias in cats?

Answer 30

lymphoma
then carcinomas

Question 31

is there a breed disposition to intranasal neoplasias?

Answer 31

no

Question 32

what would facial deformity indicate?

Answer 32

neoplasia most likely
poorer prognosis for neoplasia

Question 33

how is intranasal neoplasia treated?

Answer 33

high energy radiation without surgery
complete excision with surgery impossible

Question 34

who usually gets cleft palate?

Answer 34

dogs>cats
purebreds>mixed
females>males

Question 35

what is primary cleft palate?

Answer 35

lip and premaxilla

Question 36

what is secondary cleft palate?

Answer 36

hard and soft palates

Question 37

what is the most common surgical technique for cleft palate (secondary)?

Answer 37

von lagenbeck/sliding bipedicle flaps