Chapter 157 Signs of otitis media and vestibular disease can be seen when there is extension of disease from the nasopharynx into the tympanic bulla (or vice versa) or when the opening to the auditory (eustachian) tube is occluded. In one study, bullous effusion, considered most consistent with acute effusive disease, occurred in 34% of all cats with nasopharyngeal disease and 100% of cats with caudal nasopharyngeal disease (Detweiler et al, 2006). Thickening of the soft palate and reduced nasopharyngeal aperture have also been associated with the development of effusive otitis media in cavalier King Charles spaniels (Hayes et al, 2010). Conversely, expansile middle ear disease can cause nasopharyngeal obstruction. Horner’s syndrome is commonly encountered in cats with involvement of the tympanic bullae. Deafness and signs of otic pain may occur, and there also may be signs of facial nerve dysfunction. Occasionally, the main presenting signs are neurologic, resulting from the spread of infection (such as cryptococcosis) or neoplasia, or signs may be related to the gastrointestinal tract (megaesophagus or hiatal hernia). Computed tomography (CT) is increasingly used to assess the precise anatomic location of nasopharyngeal lesions and the involvement of other structures such as the middle ear, cribriform plate, brain, and bones of the skull. Use of a restraining device such as the VetMouse Trap allows CT to be performed in the conscious sedated small animal patient; however, assessment of the nasopharyngeal lumen and soft palate dimensions is reportedly more accurate with open-mouth positioning (Laurenson et al, 2011). CT is much quicker to perform than a full series of skull radiographs and is the preferred option if a mass is suspected. The results of cytologic analysis of squash-preparation specimens from nasopharyngeal masses in the cat showed good correlation with histologic findings in one study (De Lorenzi et al, 2008), although histopathologic analysis was recommended for differentiating lymphoma from lymphoid reaction. Cytologic examination and culture of nasal swabs may detect organisms such as Cryptococcus spp., but cats and dogs can have asymptomatic carriage of Cryptococcus spp. in the nasal cavity. Serologic testing is useful to differentiate asymptomatic carriage of Cryptococcus spp. from infection because animals with cryptococcosis should have a positive result on the latex cryptococcal antigen agglutination test.
Nasopharyngeal Disorders
Clinical Signs of Nasopharyngeal Disease
Diagnosis of Nasopharyngeal Disease
Diagnostic Imaging
Adjunctive Tests for Diagnosis of Nasopharyngeal Disease
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Nasopharyngeal Disorders
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