Page 244 - Clinical Manual of Small Animal Endosurgery

232 Clinical Manual of Small Animal Endosurgery

without a surgical intervention, significant magnification and very low
surgical morbidity. Patients recover from these procedures quickly and
are often discharged on the day of the procedure with minimal need for
significant aftercare by the owners.
Rhinosinusoscopy, pharyngoscopy and tracheoscopy can be used to
diagnose and manage chronic infectious diseases (both bacterial and
fungal), foreign bodies of the airways, congenital malformations, and
both benign and malignant neoplasms. The use of diode lasers has
allowed for expansion of the modalities from simply diagnostic to thera-
peutic, as laser surgery is often an excellent adjunctive therapy to other
therapeutic modalities for a variety of pathological conditions.

Indications

The common presenting clinical signs in most canine and feline patients
that should lead the clinician to include upper respiratory endoscopy in
their armament of diagnostic modalities include coughing, sneezing and
stertorous or stridorous breathing. This can also be accompanied by
chronic nasal (or oculonasal) discharge of a serous, mucoid or mucopu-
rulent nature. Epistaxis and/or haemoptysis are often noted. Other
common presenting clinical signs include halitosis (unexplained by simple
dental disease), facial pruritis or pain, facial deformity, difficulty in pre-
hension and mastication of food, and exophthalmos. Certain of these
presentations are easier to appreciate in mesocephalic or dolicocephalic
dogs but with careful examination these clinical signs can be appreciated
in most canine and feline breeds.

Instrumentation

There is a wide variety of instrumentation available on both the new and
used equipment markets. Equipment choices, use, care and maintenance
are discussed elsewhere, but a brief overview of clinically relevant equip-
ment is appropriate here.
A high-quality endoscopic video camera is requisite for performing
meaningful endoscopic examinations. Less-expensive single-chip camera-
coupling device (CCD) cameras, as well as more costly three-chip CCD
and high-definition (HD) cameras are available and all perform well.
Higher-quality cameras should be paired with appropriate high-quality
monitors to maximise the quality of the resultant image. That said,
single-chip cameras provide excellent visualisation and resolution. Prac-
titioners collecting images for use in publications or presentations will
appreciate the improved image quality with three-chip or HD cameras.
A light source with a flexible fibre-optic light guide cable is also
needed. Halogen, xenon and metal halide light sources are available at
a variety of cost points. This author prefers the use of a xenon light