Felis ISSN 2398-2950

Nasopharyngeal polyp removal

Contributor(s): Andrew Gardiner, Anna Cronin

Introduction

  • Surgical excision of an aural or nasopharyngeal polyp.
  • Signs:
    • Aural polyps: chronic otitis externa, head shaking, otorrhea, waxy or purulent discharge.
    • Nasopharyngeal polyps: nasal discharge, stertorous breathing, reverse sneezing, sneezing, can interfere with swallowing.
  • Unknown etiology, however it is speculated that the polyps could be congenital or a response to an inflammatory process, eg cats that have experienced an episode of upper respiratory viral infection.
  • Location of polyps:
    • Originates from the epithelium of the tympanic bulla and/or auditory tube.
    • Polyps can be seen in the external auditory meatus, in both cavities in the feline bulla and extending through the auditory tube into the nasopharynx.
  • Diagnosis:
    • Otoscopy or video-otoscopy.
    • Radiographs - open mouth view rostroventral-caudodorsal, lateral view can be tilted 30˚ to assess nasopharyngeal polyps.
    • Advanced imaging such at contrast enhanced CT or MRI is advised in challenging and recurrent cases.   

Uses

Advantages

  • Rapid improvement of upper airway obstruction caused by nasopharyngeal polyps.
  • Can be used to improve treatment of otitis externa Otitis externa/media Otitis media exacerbated by polyps.
  • Minimal specialist equipment required.

Disadvantages

  • Recurrence, risk higher when there has been inadequate removal of the polyp or its stalk.
  • Ventral bulla osteotomy Bulla osteotomy may be required.
  • Very rarely splitting of the soft palate.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good when treated postopertively with prednisolone after traction/avulsion.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Greci V & Mortellaro C M (2016) Management of Otic and Nasopharyngeal, and Nasal Polyps in Cats and Dogs. Vet Clin North Am Small Anim Pract 46 (4), 643-661 PubMed.
  • Greci V, Vernia E, Mortellaro C M (2013) Per-endoscopic trans-tympanic traction for the management of feline aural inflammatory polyps: a case review of 37 cats. J Feline Med Surg 16 (8), 645-650 PubMed.
  • Reed N & Gunn-Moore D (2012) Nasopharyngeal disease in cats: 1. Diagnostic investigation. J Feline Med Surg 14 (5), 306-315 PubMed.
  • MacPhail C M, Innocenti C M, Kudnig S T et al (2007) Atypical manifestations of feline inflammatory polyps in three cats. J Feline Med Surg (3), 219-225 PubMed.
  • Bischoff M G & Kneller S K (2004) Diagnostic imaging of the canine and feline ear. Vet Clin North Am Small Anim Pract 34 (2), 437-458 PubMed.
  • Kudnig S T (2002) Nasopharyngeal polyps in cats. Clin Tech Small Anim Pract 17 (4), 174-177 PubMed.
  • Anderson D M, Robinson R K & White R A (2000) Management of inflammatory polyps in 37 cats. Vet Rec 147 (24), 684-687 PubMed.
  • Faulkner J E & Budsberg S C (1990) Results of ventral bulla osteotomy for treatment of middle ear polyps in cats. JAAHA 26 (5), 496-499 VetMedResource.

Other sources of information

  • Tobias K M & Johnston S A (2012) Veterinary Surgery Small Animal. 2nd edn. W B Saunders.


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