Interventional treatment of benign nasopharyngeal stenosis and imperforate nasopharynx in dogs and cats: 46 cases (2005-2013).

OBJECTIVE To determine outcome for dogs and cats with benign nasopharyngeal stenosis or an imperforate nasopharynx that underwent balloon dilatation or metallic stent placement. DESIGN Retrospective case series. ANIMALS 15 dogs and 31 cats. PROCEDURES Medical records were retrospectively reviewed, and data on signalment, history, clinical signs, lesion location, treatment, and outcome were obtained. Patients were excluded if < 6 months of follow-up information was available. RESULTS 5 dogs and 22 cats underwent balloon dilatation, and results were successful in 11 (0 dogs and 11 cats) of the 27 (41%). Stents were placed in 34 patients (including 15 in which balloon dilatation had been unsuccessful). Uncovered stents were placed in 30 patients, and results were successful in 20 (67%). Covered stents were placed in 11 patients (including 7 in which uncovered stent placement was unsuccessful), and results were successful in all 11. Twenty-three of the 34 (68%) patients in which stents were placed developed complications. The most common complications were tissue ingrowth (n = 10), chronic infection (7), and stent fracture (5) for the 30 patients with uncovered stents and chronic infection (8) and oronasal fistula (3) for the 11 patients with covered stents. Overall, outcome was successful in 36 of the 46 (78%) patients (median follow-up time, 24 months; range, 2 to 109 months). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in dogs and cats, nasopharyngeal stenosis and imperforate nasopharynx can be successfully treated with balloon dilatation or stent placement, but that there was a high risk of failure with balloon dilatation alone and a high risk of complications regardless of procedure.

Thornwaldt cysts.

Thornwaldt cysts are rare and benign congenital cysts in the region of the pharyngeal bursa, formed by a communication between the notochord and the nasopharyngeal endoderm. They result from a mechanical obstruction, inflammation, or abscess of the pharyngeal bursa. They are superficial to the superior constrictor muscle and covered by the nasopharyngeal mucous membrane. Most cases are asymptomatic, and patients may rarely present symptoms such as nasal obstruction, foreign body sensation, hearing loss, and periodic halitosis. Therefore, they are often accidentally diagnosed on MRI. Asymptomatic cysts do not require treatment, whereas symptomatic cases require surgical intervention by endonasal or transoral approach. Marsupialization is the procedure of choice to avoid recurrences. The aim of this article is to present and discuss 2 cases of Thornwaldt cysts.

Hairy polyp can be lethal even when small in size.

A case of sudden cardiopulmonary arrest in a 3-month-old girl is presented. The patient had barely recovered from hypoxic encephalopathy when she presented with repeated respiratory distress. Computed tomography and endoscopic analysis revealed a shiny polyp in the lateral wall of the nasopharynx, and this polyp was suspected to be the main cause of respiratory distress. After referral to our hospital, surgical removal was performed, and the histopathological diagnosis was hairy polyp. Hairy polyp is a rare congenital benign tumor that sometimes induces respiratory distress. This polyp can potentially induce a life-threatening event. In a systematic review of 40 reported cases, polyps of ≤ 3.0 cm in diameter have a higher risk of respiratory distress than do those >3.0 cm in diameter (P = 0.01). Small hairy polyps may be lethal because of delayed diagnosis. To locate small hairy polyps, physicians should not hesitate to perform further examination because there is the possibility of oversight with only physical examination.

Parapharyngeal neuroglial heterotopia extending through the skull base in a neonate with airway obstruction.

We present a neonate with heterotopic nasopharyngeal brain tissue causing airway obstruction. Preoperative imaging showed extension of the mass along major neurovascular pathways into the cranial vault. Preoperative identification of intracranial extension is essential for planning surgery to prevent postoperative cerebrospinal fluid leaks or possible meningitis.

Stenotic nasopharyngeal dysgenesis in the dachshund: seven cases (2002-2004).

Medical records of seven dachshunds with congenital nasopharyngeal stenosis from abnormally thickened palatopharyngeal muscles were reviewed. The intrapharyngeal ostium in all cases consisted of only a narrow slit. Dogs were presented with various clinical signs--the most common being dyspnea, expiratory cheek puff, salivation, pharyngeal dysphagia, oral dysphagia (to a lesser extent), and macroglossia. Diagnostic procedures included direct pharyngeal inspection, pharyngeal and thoracic radiography, fluoroscopy, lingual ultrasonography, biopsies in two dogs, and a postmortem examination in one dog. Diagnoses were readily made with radiographs and visual examinations. Macroglossia was confirmed with transcutaneous ultrasonography or a transmandibular finger test.

Lateral nasopharyngeal cysts. A case report.

A case of congenital lateral pharyngeal cyst is reported and a classification of pharyngeal cysts is given.

[A contribution to Tornwaldt's disease (author's transl)]. / Ein Beitrag zur Tornwaldt-Krankheit.

The signs of Tornwaldt's disease, such as postnasal discharge, increase of mucous secretion, dysfunction of the eustachian tube, sometimes associated with middle-ear infection, are now rarely seen in comparison to the 19th century. In this article, we report about a sign of Tornwaldt's disease which had not been described up to now: A troublesome expiratory whistle. The resection of the bursal wall eliminated this sign. The short-term whistle as the only sign of Tornwaldt's disease, without histological signs of inflammation, underlines Tornwaldt's idea that inflammation is a secondary reaction of nasopharyngeal cysts.

Enterogenic cyst of the nasopharynx.

An 'enterogenic cyst' of the nasopharynx is presented. The term 'enterogenic' is preferred to the currently used term 'cyst of the bursa pharyngea embryonalis'.