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Feline Nasopharyngeal Polyps. Erica Fields, DVM Nov. 16, 2009 Acc # 124825. Maddie. MRN 152368 6 year old FS DSH Purulent left ear discharge for 2 mos Fleshy pink mass visible in external ear canal. CT images. CT images. Differential Diagnoses. Inflam. polyp - PowerPoint PPT Presentation
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Feline Nasopharyngeal PolypsErica Fields, DVMNov. 16, 2009Acc # 124825
MaddieMRN 1523686 year old FS DSHPurulent left ear discharge for 2
mosFleshy pink mass visible in
external ear canal
CT images
CT images
Fan and de Lorimier, 2004
Differential Diagnoses
Inflam. polypNeoplasia* –
external canal ◦ Ceruminous gland
adenoma◦ SCC◦ Sebaceous gland
adenocarcinoma
Neoplasia* – middle ear◦ Carcinomas (esp.
SCC)◦ LSA◦ FSA◦ Cholesteatoma
(esp. dogs)* 87.5 % of feline ear canal tumors are malignant
Fan and de Lorimier, 2004 and Seitz, et al, 1996
Inflammatory (Nasopharyngeal) PolypsArise from mucosa of middle ear, auditory
tube, or pharynxLoose fibrovascular tissue covered by epithelial
layer, with mixed inflammatory infiltratesPresence of ciliated epithelium is
characteristic, but not always seenEtiology unknown
◦ Congenital?◦ Chronic URT inflammation?◦ Viral (Calicivirus, Herpesvirus-1)?◦ Chronic otitis media?◦ Ascending nasopharyngeal infection?
www.adelaidevet.com.au
Fan and de Lorimier, 2004 and Cook, et al, 2003
Young cats – most are under 3 yo (mean is 24 mos)
Most unilateral, but can be bilateralAbyssinians overrepresentedClinical signs:
◦Upper respiratory (sneezing, dysphonia, dyspnea, dysphagia, stertor, nasal dc)
◦Otitis media/interna (head tilt, nystagmus, Horner’s syndrome)
◦Otitis externa (otorrhea, head shaking)◦Can extend to cerebellum, temporal lobe,
or brainstem!
www.acfacat.com
Seitz, et al, 1996 and Fan and de Lorimier, 2004
Diagnosis◦Otoscopy◦Oropharyngeal examination◦IMAGING
Radiographs – open-mouth skull, plus thorax (look for lower respiratory tract signs)
CT Less superimposition Can see brain extension Better detail and localization
Treatment◦Must know location to select right
procedure!◦Traction vs. VBO/TECA
veterinarynews.dvm360.com
Carcinoma
Carcinoma
Cholesteatoma
ReferencesCook LB, Bergman RL, Bahr A, Boothe HW.
2003. Inflammatory polyp in the middle ear with secondary suppurative meningoencephalitis in a cat. Veterinary Radiology and Ultrasound. 44(6): 648-651.
Fan TM and de Lorimier L-P. 2004. Inflammatory polyps and aural neoplasia. Veterinary Clinics: Small Animal Practice. 34: 489-509.
Seitz SE, Losonsky JM, Maretta SM. 1996. Computed tomographic appearance of inflammatory polyps in three cats. Veterinary Radiology and Ultrasound. 37 (2): 99-104.