surgery of the oropharynx

Question 1

what are otopharyngeal polyps?

Answer 1

Inflammatory polyps originating from the middle ear, nasopharynx or eustachian tube –> common in younger cats

Typically disease starts in middle ear –> breaks through membrane into external ear OR back into eustachian tube.

Question 2

CS of nasopharyngeal obstruction

Answer 2

• chronic nasal discharge
• sneezing
• gagging
• stertorous breathing

Question 3

CS of middle ear disease

Answer 3

• head tilt
• nystagmus
• horner’s

Question 4

CS of otitis externa

Answer 4

• discharge

- scratching, shaking

Question 5

Treatments of otopharyngeal polyps

Answer 5

1. Traction-avulsion (recurrent 50% + bleeding)

2. Surgical - ventral bulla osteotomy/soft palate incision

Question 6

what structures are found in the smaller dorsal compartment of the bulla?

Answer 6

• promontory
• auditory ossicles
• sympathetic n

Question 7

what is the prognosis for otopharyngeal polyps?

Answer 7

good to excellent w/ surgical removal

Question 8

list the salivary glands

Answer 8

1. Parotid
2. Mandibular
3. Sublingual
4. Zygomatic
5. Buccal

Question 9

non-neoplastic diseases of the salivary gland DDx

Answer 9

• sialoadenitis
• sialoliths
• rupture

Question 10

which salivary glands are predisposition sites for neoplasia in the dog vs cat?

Answer 10

Dog - parotid

Cat - mandibular

Question 11

what neoplasia is most common in salivary glands?

Answer 11

Adenocarcinomas –> gland enlargement –> mets to local LNs

Question 12

what is a mucocele?

Answer 12

accumulation of saliva w/in tissue

Question 13

Ddx for swelling at back of pharynx near tonsillar crypts

Answer 13

Sublingual sialoceles (ranulas), pharyngeal sialoceles, neoplasia

Question 14

clinical features of sialoceles

Answer 14

Soft to firm, often non-painful, non-inflamed swelling caudal to the angle of the mandible (+/- ventral neck)

+ pharyngeal protrusion
+ elongated fluid accumulations underneath or adjacent to tongue

Question 15

Dx of mucocele/sialocele

Answer 15

• aspiration of clear to honey-coloured, viscid saliva

Question 16

Tx of sialoceles

Answer 16

Removal of the sublingual salivary gland

–> need to resect mandibular as well for visualisation

Question 17

what is the difference between a primary and secondary palate?

Answer 17

Primary = lips and premaxilla
Secondary = hard and soft palates

Question 18

what is a secondary cleft palate?

Answer 18

1. Rostral midline defect = failure of fusion of nasomedial process w/ the maxillary process
2. Failure of fusion of lateral palate processes

Question 19

Acquired cleft palates can arise from?

Answer 19

• dental disease
• trauma
• oral disease (lymphocytic-plasmacytic stomatitis)

Question 20

Another name for an acquired cleft palate is..

Answer 20

oronasal fistulae

Question 21

a primary cleft palate rarely causes clinical disease – repair is mainly…

Answer 21

cosmetic

Question 22

pharyngeal injury requires…what imaging?

Answer 22

CT to properly assess

Question 23

Treatment of pharyngeal injuries (after stabilisation)

Answer 23

1. Wound debridement
   - leave oral wound open
   - deep tissue culture of neck
   - oesophageal feeding tube
   - CT for further exploration
   - antibiotics

Question 24

sequelae of pharyngeal stick injuries

Answer 24

• migration
• abscessation
• diskospondylitis