Nasal Disease: Surgical Approach to the Nasal Cavity Flashcards
(36 cards)
The most frequent tumour to affect the nasal planum is the
SCC
Are dogs or cats nasal planum tumour more likely to need surgery as more invasive on presentation?
Dogs
Where do nasal planum tumours often originate in dogs?
Nasal vestibule
How to perform diagnostic biopsies of nasal planum?
- Scalpel slice
- Punch
Normal met site of SCC of the nasal planum?
LN
The prognosis for tumours that have metastasised to the lymph node?
May be guarded
If a SCC has met to the LN, what other met check needed?
Thorax (xray vs ct)
Treatment options in SCC in cats (superficial) (3)
- Photodynamic
- Strontium
- Curettage with cautery
Define deep nasal tumour?
> 5mm
Tx for deep nasal lesion?
Nasal planectomy
How to mark histo edges for the pathologist?
Indian ink
What blood test should be performed before nasal surgery?
Coagulopathy
Pre op planning with planectomies; what should be included? (3)
- Blood profiles and BMBT
- MRI scan unless very superficial lesion (most dogs require advanced imaging, cats are usually more superficial)
- Lots of owner preparation (particularly if young children in the family).
For clean surgical margins of? is usually sufficient.
a 1 cm
Nasal planectomy; nerve blocks?
infra orbital
Surgical prep in cats for nasal planectomy:
Do you leave whiskers in place?
If poss
Surgical prep in cats for nasal planectomy:
Surgically prep with what? (2)
The oral cavity prepped with a dilute povidone-iodine solution or aqueous chlorhexidine.
Surgical prep in cats for nasal planectomy:
Position?
ventral recumbency with the mouth slightly opened using a mouth gag.
Surgical prep in cats for nasal planectomy:
Surgical margins? What happens if not possible?
1cm; if this isnt poss a 0.5 cm margin will often result in clean surgical margins.
Surgical prep in cats for nasal planectomy:
For larger tumours, or those situated more ventrally, the nasal planectomy should be combined with
pre-maxillectomy.
What should be left in place during a cat nasal planectomy to aid recontruction?
A small strip of skin is left in place at the rostral lip
The lips are very vascular and haemostasis is provided by (4)
electrosurgery,
artery forceps
ligation
Ice cold saline soaked swabs
In cases where only the nasal planum has been resected, how to reconstruct?
skin can be sutured to the maxilla using simple interrupted rolling sutures or a purse string suture.
How to place an simple interrupted rolling suture?
anchoring the skin through holes made in the maxilla using K-wires
