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Nasopharyngeal Stenosis 683.e3

Acute General Treatment stent fracture (15%), oronasal fistulas (20%), Client Education
Restoration of nasopharyngeal patency: stent migration (8.8%) Recurrence is possible.
VetBooks.ir • Dilation of the stenosis with a valvuloplasty Recommended Monitoring SUGGESTED READING Diseases and Disorders
• Surgical/laser resection of a stenotic mem-
brane or mass
Clinical signs
Berent AC, et al: Use of a balloon-expandable metallic
balloon dilation (BD) catheter is performed
under endoscopic or fluoroscopic guidance. PROGNOSIS & OUTCOME stent for treatment of nasopharyngeal stenosis in
dogs and cats: six cases (2005-2007). J Am Vet
Anecdotally, BD is used as first-line treatment Med Assoc 233:1432-1440, 2008.
for small lesions (<5 mm), with 30%-50% • Depends on the ability to restore nasopha-
success rates reported. ryngeal patency ADDITIONAL SUGGESTED
• Placement of a stent across the stenotic region • Long-term resolution of clinical signs has READINGS
uses combined endoscopic and fluoroscopic been achieved with BD and stents in patients Glaus TM, et al: Reproducible and long-lasting
guidance. Stent placement may be permanent with non-neoplastic acquired stenosis. success of balloon dilation of nasopharyngeal
or temporary. Permanent stents are reported • Tissue ingrowth was more likely to occur stenosis in cats. Vet Rec 157:257-259, 2005.
to maintain patency in up to 67% of cases. in patients with imperforate stenosis (67%) Henderson SM, et al: Investigation of nasal disease
Temporary stents were placed after BD, than patent stenosis (25%). in the cat—a retrospective study of 77 cases. J
with maintained patency in 14/15 cats in a Feline Med Surg 6:245-257, 2004.
single study, but they were poorly tolerated PEARLS & CONSIDERATIONS Hunt GB, et al: Nasopharyngeal disorders. In Kirk
RW, et al, editors: Current veterinary therapy XIV,
by patients (complications were reported in St. Louis, 2009, Saunders, pp 622-626.
65% of cases). Comments Kirberger RM, et al: Stenotic nasopharyngeal dysgen-
The underlying cause of nasopharyngeal stenosis esis in the Dachshund: seven cases (2002-2004). J
Chronic Treatment is often unidentified; reflux or chronic rhinitis Am Anim Hosp Assoc 42:290-297, 2006.
• Antiinflammatory doses of glucocorticoids should be considered. Mitten RW: Acquired nasopharyngeal stenosis in
after surgery/dilation cats. In Kirk RW, et al, editors: Current veterinary
• Other treatments (surgery, chemotherapy, Prevention therapy XI. Philadelphia, 1992, WB Saunders, pp
radiation therapy) for neoplastic causes Conditions that predispose to nasopharyngeal 801-803.
(p. 680) stenosis are difficult to predict, prevent, or
• Stenting may have palliative benefit for treat, and prevention of stenosis is likewise RELATED CLIENT EDUCATION
neoplastic stenosis. difficult. SHEETS
Possible Complications Technician Tips Consent to Perform Computerized Tomography
Recurrence of stenosis is common, especially • Be prepared for rapid endotracheal intubation (CT Scan)
for imperforate lesions. of affected cats after anesthesia has been Consent to Perform General Anesthesia
• BD: 70% recurrence after a single BD and induced. AUTHOR: Remo Lobetti, BVSc, MMedVet, PhD,
60% recurrence after 1-3 BD procedures • Feed small, frequent meals of a soft consis- DECVIM
• Stent placement: recurrence (≈30%, may vary tency, especially after surgery. EDITOR: Megan Grobman, DVM, MS, DACVIM
with stent type), chronic infection (38%),

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