Page 67 - BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery, 2nd Edition

BSAVA Manual of Canine and Feline Head, Neck and Thoracic Surgery

Sharp NJH, Harvey CE and O’Brien JA (1991a) Treatment of canine nasal aspergil- Venker-van Haagen AJ (2005) The nose and nasal sinuses. In: Ear, Nose, Throat,
losis penicilliosis with flucona ole. Journal of Small Animal Practice 32, 513–516 and Tracheobronchial Diseases in Dogs and Cat, ed. AJ Venker-van Haagen, pp.
51–81. Schlütersche, Hannover
Sharp NJH, Harvey CE and Sullivan M (1991b) Canine nasal aspergillosis and penicil-
VetBooks.ir liosis. Compendium on Continuing Education for the Practicing Veterinarian 13, 41–46 White D (2006) Canine nasal mycosis – light at the end of a long diagnostic and
therapeutic tunnel. Journal of Small Animal Practice 47, 307
Sharp NJH, Sullivan M, Harvey CE and Webb T (1993) Treatment of canine nasal
aspergillosis with enilconazole. Journal of Veterinary Internal Medicine 7, 40–43
Whitney J, Beatty JA, Martin P et al. (2013) Evaluation of serum galactomannan
Sissener TR, Bacon NJ, Friend E, Anderson DM and White RA (2006) Combined
clotrimazole irrigation and depot therapy for canine nasal aspergillosis. Journal detection for diagnosis of feline upper respiratory tract aspergillosis. Veterinary
Microbiology 162, 180–185
of Small Animal Practice 47, 312–315
Wiestner TS, Koch DA, Nad N et al. (2007) Evaluation of the repeatability of
Smith N and Ho man SB ( 1 ) A case series of unilateral orbital aspergillosis in rhinomanometry and its use in assessing transnasal resistance and pressure in
three cats and treatment with voriconazole. Veterinary Ophthalmology 13, 190–203 dogs. American Journal of Veterinary Research 68, 178–184
Tasker S, Knottenbelt CM, Munro EA et al. (1999) Aetiology and diagnosis of Wilkinson GT, Sutton RH and Grono LR (1982) Aspergillus spp. infection
persistent nasal disease in the dog: a retrospective study of 42 cases. Journal of associated with orbital cellulitis and sinusitis in a cat. Journal of Small Animal
Small Animal Practice 40, 473–478
Practice 23, 127–131
ter Haar G, Buiks SC and Kirpensteijn J (2013) Cosmetic reconstruction of a Willard MD and Radlinsky MA (1999) Endoscopic examination of the choanae in
nasal plane and rostral nasal skin defect using a modified nasal rotation flap in a dogs and cats: 118 cases (1988–1998). Journal of the American Veterinary
dog. Veterinary Surgery 42, 176–179
Medical Association 215, 1301–1305
ter Haar G and Hampel R (2015) Combined rostrolateral rhinotomy for removal of
rostral nasal septum squamous cell carcinoma: long-term outcome in 10 dogs. Windsor RC, Johnson LR, Herrgesell EJ and De Cock HEV (2004) Idiopathic
lymphoplasmacytic rhinitis in dogs: 37 cases (1997–2002). Journal of the
Veterinary Surgery 44, 843–851
American Veterinary Medical Association 224, 1952–1957
Theon AP, Madewell BR, Harb MF and Dungworth DL (1993) Megavoltage
irradiation of neoplasms of the nasal and paranasal cavities in 77 dogs. Journal Withrow SJ (2013) Cancer of the nasal planum. In: Small Animal Clinical
of the American Veterinary Medical Association 202, 1469–1475 Oncology, 5th edn, ed. SJ Withrow, DM Vail and RL Page, pp. 432–435. Elsevier
Saunders, St Louis
Tomlinson MJ and Schenck NL (1975) Autogenous fat implantation as a
treatment for chronic frontal sinusitis in a cat. Journal of the American Withrow SJ and Straw RC (1990) Resection of the nasal planum in nine cats and
Veterinary Medical Association 167, 927–930 five dogs. Journal of the American Animal Hospital Association 26, 219–222
Tomsa K, Glaus TM, Zimmer C and Greene CE (2003) Fungal rhinitis and Wolf AM and Troy GC (1995) Deep mycotic diseases. In: Textbook of Veterinary
sinusitis in three cats. Journal of the American Veterinary Medical Association Internal Medicine, 4th edn, ed. SJ Ettinger and EC Feldman, pp. 455–458. WB
222, 1380–1384 Saunders, Philadelphia
Turek MM and Lana SE (2013) Nasosinal tumors. In: Small Animal Clinical Zonderland J-L, Störk CK, Saunders JH et al. (2002) Intranasal infusion of
Oncology, 5th edn, ed. SJ Withrow, DM Vail and RL Page, pp. 435–451. Elsevier enilconazole for treatment of sinonasal aspergillosis in dogs. Journal of the
Saunders, St Louis American Veterinary Medical Association 221, 1421–1425
OPERATIVE TECHNIQUE 4.1

Dorsal rhinotomy

PATIENT POSITIONING
The patient is positioned in sternal recumbency, with the dorsum of the head clipped and prepared aseptically for
surgery. The tip of the nose should be pointing down slightly to facilitate blood exiting the nose, and a roll of bandage
material is positioned between the upper and lower jaws to prevent injury to the soft tissues of the oral cavity caused
by pressure from the teeth while performing the rhinotomy.

ASSISTANT
Optional.

SURGICAL TECHNIQUE
Approach
A dorsal midline skin incision is made from the caudal aspect of the nasal planum to the medial canthus of the eye for
both unilateral and bilateral rhinotomy. For sinusotomy, the incision is extended caudal to the zygomatic crests of the
frontal bone.

Surgical manipulations
1 The subcutaneous tissue and periosteum are sharply incised on the midline and elevated and reflected laterally
on either or both sides of the nasal cavity with small periosteal elevators to expose the entire nasal bone.
2 Stay sutures can be placed through the skin and subcutis to aid in retraction. A rectangular window of bone
should be exposed to allow for removal of the nasal bone and part of the frontal bone. The bone flap should be as
narrow as possible, yet allow for the introduction of large curettes and rapid turbinectomy. In small dogs,
part of the maxillary bone adjacent to the nasal bone can be removed if needed.

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