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Feline Nasopharyngeal Polyps Erica Fields, DVM Nov. 16, 2009 Acc # 124825

Feline Nasopharyngeal Polyps

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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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Page 1: Feline Nasopharyngeal Polyps

Feline Nasopharyngeal PolypsErica Fields, DVMNov. 16, 2009Acc # 124825

Page 2: Feline Nasopharyngeal Polyps

MaddieMRN 1523686 year old FS DSHPurulent left ear discharge for 2

mosFleshy pink mass visible in

external ear canal

Page 3: Feline Nasopharyngeal Polyps

CT images

Page 4: Feline Nasopharyngeal Polyps

CT images

Page 5: Feline Nasopharyngeal Polyps

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

Page 6: Feline Nasopharyngeal Polyps

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

Page 7: Feline Nasopharyngeal Polyps

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

Page 8: Feline Nasopharyngeal Polyps

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

Page 9: Feline Nasopharyngeal Polyps

Carcinoma

Page 10: Feline Nasopharyngeal Polyps

Carcinoma

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Cholesteatoma

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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.