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Nasopharyngeal polyp
Introduction
- Cause: not definitely known. May be associated with upper respiratory tract infection and otitis media.
- Signs: pedunculated growths usually found in kittens/young cats.
- May involve middle ear, oropharynx, or nasopharynx.
- Can interfere with respiration.
- Diagnosis: history, clinical signs, endoscopy and histopathology.
- Treatment: surgery.
- Prognosis: good to excellent after surgery.
Print off the owner factsheet on Nasopharyngeal polyps Nasopharyngeal polyps to give to your client.
Presenting signs
- Stertor → obstruction of nasopharynx.
- Dyspnea → obstruction of nasopharynx.
- Chronic nasal discharge (unilateral usually)
.
- Otitis and aural discharge → polyp in middle ear.
- Dysphagia associated with mass lesion in nasopharynx.
- Vestibular signs/Horner's syndrome Horner's syndrome → polyp extending into middle ear.
Acute presentation
- Dyspnea if obstruction of upper respiratory tract.
Age predisposition
- Most common in young adult cats.
- Age range of 3 months to 15 years reported.
Special risks
- Anesthesia General anesthesia: overview may be complicated by obstruction of upper respiratory tract.
Pathogenesis
Etiology
- Etiology incompletely understood.
- Possibly associated with chronic inflammation of the middle ear.
- Respiratory infections, eg Calicivirus Feline calicivirus, FHV-1 Feline herpes virus: feline rhinotracheitis virus, Mycoplasma Mycoplasma haemofelis, 'Candidatus Mycoplasma haemominutum' and 'Candidatus Mycoplasma turicensis', Chlamydophila Chlamydophila felis.
- Otitis associated with Otodectes cyanotis Otodectes cynotis.
- Possible congenital etiology associated with abnormality of first pharyngeal pouch (source of development of Eustachian tube and middle ear).
Pathophysiology
- Consist of inflammatory fibrovascular connective tissue covered by stratified squamous or ciliated columnar epithelium.
- Inflammation may affect Eustachian tube function, mucociliary dysfunction and hypersecretion of mucus.
- Secondary infection may lead to formation of granulation tissue.
- Polyps may extend from Eustachian tube into:
- Nasopharynx (respiratory signs).
- External ear canal (via tympanic membrane - aural polyp).
- May be associated with secondary infection → nasal discharge.
- Depending on location → respiratory obstruction, otitis Otitis externa, vestibular disease, Horner's syndrome Horner's syndrome.
Timecourse
- Weeks/months.
Epidemiology
- Etiology not definitely known.
- Usually found in young cats/kittens.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Reed N & Gunn-Moore D (2012) Nasopharyngeal disease in cats 1. Diagnostic investigation. J Feline Med Surg 14 (5), 306-315 PubMed.
- Reed N & Gunn-Moore D (2012) Nasopharyngeal disease in cats 2. Specific conditions and their management. J Feline Med Surg 14 (5), 317-326 PubMed.
- Klose T C, MacPhail C M, Schultheiss P C et al (2010) Prevalence of select infectious agents in inflammatory aural and nasopharyngeal polyps from client owned cats. J Feline Med Surg 12 (10), 769-774 PubMed.
- Veir J K, Lappin M R, Foley J E et al (2002) Feline inflammatory polyps: historical, clinical and PCR findings for feline calicivirus and feline herpes virus-1 in 28 cases. J Feline Med Surg 4 (4), 195-199 PubMed.
- Muilenburg R K & Fry T R (2002) Feline nasopharyngeal polyps. Vet Clin North Am Small Anim Pract 32 (4), 839-849 PubMed.
- Anderson D M, Robinson R K & White R A (2000) Management of inflammatory polyps in 37 cats. JSAP 147 (24), 684-687 PubMed.
- Kopatkin A S, Mathiesen D T, Noon K E et al (1990) Results of surgery and long-term follow-up in 31 cats with nasopharyngeal polyps. JAAHA 26 (4), 387-392 VetMedResource.
Other sources of information
- Holt D E (2004) Nasopharynngeal polyps. In: Textbook of Respiratory diseases in the Dog and Cat. Ed. King L G, St Louis, Saunders, pp 310-316.
- Little C J L (1997) Nasopharyngeal polyps. In: Consultations in Feline Internal Medicine 3 Ed. August J R. W B Saunders & Co. pp 310-316.