Ear, Nose, Throat, and tracheobronchial diseases in dogs and cats

249 Pages·2005·2.859 MB·English

by  Anjop J. Venker-van Haagen

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Anjop J. Venker-van Haagen
Ear, Nose, Throat, and TracheobronchialDiseasesin Dogsand Cats
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Anjop J. Venker-van Haagen
Ear, Nose, Throat, and
Tracheobronchial Diseases
in Dogs and Cats
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Anjop J. Venker-van Haagen, DVM, PhD, DECVS
Former Associate Professor ofVeterinaryEar Nose and ThroatDiseases
FacultyofVeterinaryMedicine
DepartmentofClinicalSciencesofCompanion Animals
UtrechtUniversity, The Netherlands
© 2005, Schlütersche VerlagsgesellschaftmbH & Co. KG, Hans-Böckler-Allee 7, 30173 Hannover
E-mail: [email protected]
Printed in Germany
ISBN 3-87706-635-6
Bibliographicinformation published byDie Deutsche Bibliothek
Die Deutsche Bibliothekliststhispublication in the Deutsche Nationalbibliografie; detailed biblio-
graphicdata are available in the Internetathttp://dnb.ddb.de.
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Contents
Contents
Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . VIII 1.6.3 Tumorsofthe middle ear . . . . . . . . . 37
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IX 1.7 Trauma to the ear . . . . . . . . . . . . . . . 37
1.7.1 Trauma to the auricle . . . . . . . . . . . . . 37
1 The Ear . . . . . . . . . . . . . . . . . . . . . . . . 1 1.7.2 Auricular hematoma . . . . . . . . . . . . . 38
1.1 Functionalconsiderations. . . . . . . . . 1 1.7.3 Trauma to the externalear canal . . . 38
1.1.1 The ear assensoryorgan . . . . . . . . . 1 1.7.4 Trauma to the tympanic
membrane. . . . . . . . . . . . . . . . . . . . . . 39
1.1.2. Middle ear matchesdifferent
impedances . . . . . . . . . . . . . . . . . . . . 2 1.7.5 Trauma to the temporalbone . . . . . . 40
1.1.3 Organ ofCorti, sensoryorgan 1.8 Ototoxicity . . . . . . . . . . . . . . . . . . . . . 41
for hearing . . . . . . . . . . . . . . . . . . . . . 3 1.9 Hearing in dogsand cats . . . . . . . . . 42
1.1.4 Ascending and descending pathways 1.9.1 Hearing and hearing lossin dogs. . . 43
for hearing . . . . . . . . . . . . . . . . . . . . . 5 1.9.2 Brain stem auditoryevoked
1.1.5 Vestibular organ, the keyto postural responsesin dogs . . . . . . . . . . . . . . . 43
reflexesand eye movement . . . . . . . 5 1.9.3 Hearing and hearing lossin cats . . . 46
1.2 Historyand clinicalsigns . . . . . . . . . 6 1.9.4 Brain stem auditoryevoked responses
1.2.1 History . . . . . . . . . . . . . . . . . . . . . . . . 6 in cats. . . . . . . . . . . . . . . . . . . . . . . . . 46
1.2.2 Clinicalsigns . . . . . . . . . . . . . . . . . . . 7
1.2.3 Physicalexamination. . . . . . . . . . . . . 9 2 The Nose and NasalSinuses . . . . . . 51
1.3 Specialdiagnostictechniques . . . . . 9 2.1 Functionalconsiderations. . . . . . . . . 51
1.3.1 Otoscopicexamination . . . . . . . . . . . 10 2.1.1 Regulation and conditioning ofthe
inspiratoryand expiratoryairflow . . . 51
1.3.2 Diagnosticimaging ofthe ear . . . . . . 12
2.1.2 Mucosalcleaning . . . . . . . . . . . . . . . . 52
1.3.3 Tympanometry . . . . . . . . . . . . . . . . . . 15
2.1.3 Olfaction . . . . . . . . . . . . . . . . . . . . . . . 53
1.3.4 Neurologicalexamination for vestibular
dysfunction . . . . . . . . . . . . . . . . . . . . 16 2.1.4 Specificfunctionalsystems . . . . . . . 53
1.3.5 Hearing tests . . . . . . . . . . . . . . . . . . . 16 2.2 Historyand clinicalsigns . . . . . . . . . 53
1.4 Congenitaldiseasesofthe ear . . . . . 19 2.2.1 History . . . . . . . . . . . . . . . . . . . . . . . . 53
1.4.1 Congenitaldeformityofthe 2.2.2 Clinicalsigns . . . . . . . . . . . . . . . . . . . 54
externalear . . . . . . . . . . . . . . . . . . . . 19 2.2.3 Physicalexamination . . . . . . . . . . . . 55
1.4.2 Congenitaldeafness . . . . . . . . . . . . . 19 2.3 Specialdiagnostictechniques . . . . . 55
1.5 Inflammatorydiseasesofthe ear . . . 21 2.3.1 Diagnosticimaging . . . . . . . . . . . . . . 56
1.5.1 Primaryand secondaryskin diseasesof 2.3.2 Rhinoscopy . . . . . . . . . . . . . . . . . . . . 57
the auricle . . . . . . . . . . . . . . . . . . . . . 21 2.3.3 Olfactorytests . . . . . . . . . . . . . . . . . . 59
1.5.2 Perichondritisand chondritis 2.4 Congenitaldiseasesofthe nose
ofthe auricle . . . . . . . . . . . . . . . . . . . 23 and nasalsinuses . . . . . . . . . . . . . . . 60
1.5.3 Cold agglutination and cutaneous 2.4.1 Congenitalmalformation ofthe
vasculitisofthe auricle . . . . . . . . . . . 24 nasalplane . . . . . . . . . . . . . . . . . . . . 60
1.5.4 Inflammatorydiseasesofthe externalear 2.4.2 Nasaldermoid sinuscysts . . . . . . . . 62
canal. . . . . . . . . . . . . . . . . . . . . . . . . . 24 2.4.3 Congenitalcerebrospinalfluid fistula 62
1.5.5 Inflammation ofthe tympanic 2.4.4 Congenitalmalformation ofthe
membrane . . . . . . . . . . . . . . . . . . . . . 30 frontalsinuses . . . . . . . . . . . . . . . . . . 62
1.5.6 Inflammatorydisease ofthe 2.4.5 Congenitalciliarydysfunction . . . . . . 62
middle ear . . . . . . . . . . . . . . . . . . . . . 30 2.5 Rhinitisand sinusitis. . . . . . . . . . . . . 63
1.5.7 Labyrinthitis. . . . . . . . . . . . . . . . . . . . 34 2.5.1 Infectiousrhinitisand sinusitis . . . . 63
1.6 Tumorsofthe ear . . . . . . . . . . . . . . . . 35 2.5.2 Noninfectiousrhinitisand
1.6.1 Malignanttumorsofthe auricle . . . . 35 sinusitis. . . . . . . . . . . . . . . . . . . . . . . . 68
1.6.2 Malignanttumorsofthe external 2.6 Tumorsofthe nasalplane, the nasal
ear canal. . . . . . . . . . . . . . . . . . . . . . . 36 cavity, and the frontalsinus . . . . . . . 72
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Contents
2.6.1 Tumorsofthe nasalplane . . . . . . . . . 72 4 The Larynx . . . . . . . . . . . . . . . . . . . . . 121
2.6.2 Tumorsin the nasalcavity. . . . . . . . . 74 4.1 Functionalconsiderations. . . . . . . . . 121
2.6.3 Tumorsin the frontalsinus . . . . . . . . 74 4.1.1 The glotticclosure reflex . . . . . . . . . . 121
2.7 Trauma to the frontalsinusand 4.1.2 Respiratorymovementsofthe
the nose . . . . . . . . . . . . . . . . . . . . . . 75 glottis . . . . . . . . . . . . . . . . . . . . . . . . . 122
2.7.1 Trauma to the frontalsinus . . . . . . . . 75 4.1.3 Movementsofthe glottisin
2.7.2 Trauma to the nose . . . . . . . . . . . . . . 76 vocalization . . . . . . . . . . . . . . . . . . . . 122
2.8 Epistaxis. . . . . . . . . . . . . . . . . . . . . . . 77 4.1.4 Action ofthe glottisin coughing . . . . 122
2.8.1 Managementofacute epistaxis . . . . 77 4.1.5 Supplementaryinnervation ofthe
dog’sintrinsiclaryngealmuscles . . . 122
2.8.2 Causesofepistaxis . . . . . . . . . . . . . . 77
4.2 Historyand clinicalsigns . . . . . . . . . 124
2.8.3 The diagnosticplan . . . . . . . . . . . . . . 78
4.2.1 History. . . . . . . . . . . . . . . . . . . . . . . . . 124
2.8.4 Managementofintermittentepistaxis
ofunknown origin . . . . . . . . . . . . . . . 79 4.2.2 Clinicalsigns . . . . . . . . . . . . . . . . . . . 125
4.3 Specialdiagnostictechniques . . . . . 126
3 The Pharynx . . . . . . . . . . . . . . . . . . . . 83 4.3.1 Laryngoscopy. . . . . . . . . . . . . . . . . . . 126
3.1 Functionalconsiderations. . . . . . . . . 83 4.3.2. Diagnosticimaging ofthe larynx . . . 127
3.1.1 Auditorytube servesto equalize 4.3.3 Electromyographyofthe intrinsic
atmosphericpressure . . . . . . . . . . . 83 laryngealmuscles . . . . . . . . . . . . . . . 127
3.1.2 Swallowing . . . . . . . . . . . . . . . . . . . . . 83 4.4 Congenitaldeformitiesand
disordersofthe larynx. . . . . . . . . . . . 128
3.2 Historyand clinicalsigns . . . . . . . . . 88
4.4.1 Congenitalglottisstenosis . . . . . . . . 128
3.2.1 History . . . . . . . . . . . . . . . . . . . . . . . . 88
4.4.2 Congenitalsubglotticstenosis . . . . . 129
3.2.2 Clinicalsigns . . . . . . . . . . . . . . . . . . . 88
4.4.3 Laryngealhypoplasia . . . . . . . . . . . . 130
3.3 Specialdiagnostictechniques . . . . . 89
4.5 Laryngitis . . . . . . . . . . . . . . . . . . . . . . 132
3.3.1 Pharyngoscopy . . . . . . . . . . . . . . . . . 89
4.5.1 Benign laryngealmasses . . . . . . . . . 137
3.3.2 Diagnosticimaging ofthe pharynx. . 90
4.5.2 Ventralmidline approach to the
3.3.3 Electromyographyofthe pharyngeal
laryngealcavitiesto expose large
muscles . . . . . . . . . . . . . . . . . . . . . . . 91
masses . . . . . . . . . . . . . . . . . . . . . . . . 137
3.4 Congenitaldeformitiesand disorders
4.6 Tumorsofthe larynx . . . . . . . . . . . . . 138
ofthe pharynx . . . . . . . . . . . . . . . . . . 91
4.6.1 Historyand clinicalsignsof
3.4.1 Hypoplasia ofthe softpalate . . . . . . 91
laryngealtumors . . . . . . . . . . . . . . . . 138
3.4.2 Congenitalmalformation ofthe soft
4.6.2 Imaging oflaryngealtumors . . . . . . . 139
palate . . . . . . . . . . . . . . . . . . . . . . . . 92
4.6.3 Laryngoscopyfor laryngealtumors. . 139
3.4.3 Hyperplasia ofthe softpalate . . . . . 92
4.6.4 Therapyfor laryngealtumors . . . . . . 140
3.4.4 Choanalatresia . . . . . . . . . . . . . . . . . 93
4.7 Bluntand penetrating injuries
3.4.5 Craniopharyngioma (Rathke’spouch
tothe larynx . . . . . . . . . . . . . . . . . . . . 141
tumor) . . . . . . . . . . . . . . . . . . . . . . . . . 94
4.7.1 Bluntlaryngealinjuries . . . . . . . . . . . 142
3.5 Pharyngitis . . . . . . . . . . . . . . . . . . . . . 95
4.7.2 Penetrating laryngealinjuries. . . . . . 144
3.5.1 Nasopharyngitis. . . . . . . . . . . . . . . . . 95
4.8 Laryngealparalysisand functional
3.5.2 Oropharyngitisand tonsillitis . . . . . . 99
disordersofthe larynx. . . . . . . . . . . . 146
3.5.3 Pharyngealmucocele . . . . . . . . . . . . 101
4.8.1 Neurogeniclaryngealparalysis. . . . . 147
3.6 Tumorsofthe pharynx. . . . . . . . . . . . 101
4.8.2 Laryngealspasm . . . . . . . . . . . . . . . . 160
3.7 Bluntand penetrating injuriesofthe
4.8.3 Paradoxicalvocalfold movement. . . 161
pharynx . . . . . . . . . . . . . . . . . . . . . . . 103
4.8.4 Sensorylaryngealparalysisand
3.7.1 Bluntpharyngealinjuries . . . . . . . . . 103
laryngealdysfunction . . . . . . . . . . . . 161
3.7.2 Penetrating pharyngealinjuries . . . . 104
3.8 Dysphagia . . . . . . . . . . . . . . . . . . . . . 106
3.8.1 Causesofdysphagia . . . . . . . . . . . . . 106
3.8.2 Diagnosisin dysphagia . . . . . . . . . . . 113
3.8.3 Therapyin dysphagia . . . . . . . . . . . . 116
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Contents
5 The Trachea and Bronchi . . . . . . . . . . 167 5.5.6 Foreign bodiesin the tracheo-
5.1 Functionalconsiderations. . . . . . . . . 167 bronchialtree in dogs . . . . . . . . . . . . 191
5.1.1 Trachea and bronchi facilitate the 5.5.7 Foreign bodiesin the tracheo-
respiratoryairflow . . . . . . . . . . . . . . . 167 bronchialtree in cats. . . . . . . . . . . . . 193
5.1.2 Trachea and bronchi condition the 5.5.8 Tracheitiscaused byaspiration . . . . 193
respiratoryair . . . . . . . . . . . . . . . . . . . 167 5.6 Tumorsofthe trachea and bronchi . . 194
5.2 Historyand clinicalsigns . . . . . . . . . 168 5.7 Trachealtrauma . . . . . . . . . . . . . . . . . 195
5.2.1 History . . . . . . . . . . . . . . . . . . . . . . . . 168 5.7.1 Trauma to the cervicaltrachea . . . . . 196
5.2.2 Clinicalsigns . . . . . . . . . . . . . . . . . . . 169 5.7.2 Trauma to the thoracictrachea . . . . . 197
5.2.3 Physicalexamination . . . . . . . . . . . . 170 5.7.3 Trachealstenosis. . . . . . . . . . . . . . . . 198
5.3 Specialdiagnostictechniques . . . . . 171 5.8 Airwaymanagement . . . . . . . . . . . . . 199
5.3.1 Diagnosticimaging . . . . . . . . . . . . . . 172 5.8.1 Endotrachealintubation . . . . . . . . . . 200
5.3.2 Bronchoscopy . . . . . . . . . . . . . . . . . . 172 5.8.2 Cricothyroidotomy . . . . . . . . . . . . . . . 202
5.4 Congenitaldiseasesofthe trachea 5.8.3 Tracheostomy. . . . . . . . . . . . . . . . . . . 202
and the bronchi . . . . . . . . . . . . . . . . . 175 5.8.4 Permanenttracheostoma . . . . . . . . . 203
5.4.1 Hypoplasia ofthe trachea . . . . . . . . . 175 5.8.5 TrachealT-tube . . . . . . . . . . . . . . . . . . 205
5.4.2. Collapse ofthe trachea . . . . . . . . . . . 181
5.4.3 Segmentaltrachealstenosis. . . . . . . 183 6 CranialNeuralgiasand Facialand
5.4.4 Congenitalciliarydysfunction . . . . . . 183 TrigeminalParalysis . . . . . . . . . . . . . 209
5.5 Tracheitisand bronchitis. . . . . . . . . . 184 6.1 Cranialneuralgias . . . . . . . . . . . . . . . 209
5.5.1 Infectioustracheobronchitis 6.1.1 Glossopharyngealneuralgia . . . . . . . 209
in dogs . . . . . . . . . . . . . . . . . . . . . . . . 185 6.1.2 Trigeminalneuralgia . . . . . . . . . . . . . 209
5.5.2 Infectioustracheobronchitis 6.2 Facialand trigeminalparalysis . . . . . 210
in cats. . . . . . . . . . . . . . . . . . . . . . . . . 187
6.2.1 Facialparalysis . . . . . . . . . . . . . . . . . 210
5.5.3 Noninfectioustracheobronchitis . . . 187
6.2.2 Trigeminalparalysis. . . . . . . . . . . . . . 211
5.5.4 Bronchiectasis . . . . . . . . . . . . . . . . . . 189
5.5.5 Prolapse ofthe dorsalligamentof
trachea and main stem bronchi . . . . 189
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Abbreviations
Abbreviations
ADC Analog-to-digitalconverter kHz Kilohertz
B.O.S. Brachycephalicobstructive MRI Magneticresonance imaging
syndrome
Nd-YAG laser Laser using Yttrium-Aluminum-
BAER Brain stem auditoryevoked Garnetwith Nd ions
response
NSAIDs Nonsteroidalanti-inflammatory
BERA Brain stem evoked response drugs
audiometry
NTS Nucleustractussolitarius
CPG Centralpattern generator
p<0.01 The probabilitythatthe resultis
CRDs Complexrepetitive discharges due to chance islessthan 1 in
100 (highlysignificant)
CT Computed tomography
P generation Parentgeneration
DAC Digital-to-analog converter
SLN Superior laryngealnerve/Cranial
dB SPL Decibelsound pressure level
laryngealnerve
ECG Electrocardiogram
T-tube T-shaped trachealtube
EEG Electroencephalogram
V Trigeminalnerve
EMG Electromyogram/Electromy-
VII Facialnerve
ography
IX Glossopharyngealnerve
Fgenerations Offspring generations
X Vagusnerve
FISH and RH Methodsfor gene mapping used
mapping for association studies Xph Pharyngealbranch ofthe vagus
nerve
Hz Hertz
XII Hypoglossalnerve
i.d. Inside diameter
Ig Immunoglobulin
VIII
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Preface
Preface
Among myfellow membersofthe International intended to provide information of interest to
Veterinary Ear Nose and Throat Association academics as well as practitioners and stu-
(IVENTA), the reason for marking outspecializa- dents.
tion in diseasesofthe ear, nose, throat, and tra- I am gratefulto Dr. Bruce Belshaw for editing
cheobronchialtree isclear. Theyrecognize that the English language with care and experience.
manyofthe diseasesofthese organshave sim- Mr. Joop Fama handled the figures and made
ilar clinicalsigns, similar infectiousetiology, or them shine, and I am grateful both for his
similar regulatorymechanisms, and thatthese knowledge and for the time and care he gave to
organsshare cranialnervesfor the execution of the work. Dr. Ulrike Oslage atSchlütersche Ver-
their functions. lagsgesellschaft invited me to write this text-
Mostofthe knowledge in thisfield hasbeen bookand I thankher notonlyfor the opportu-
provided to veterinarians—and regularly up- nity but also for the free hand which I had in
dated by—the major textbooksofsmallanimal preparing it. Dr. Simone Bellair atSchlütersche
internalmedicine and smallanimalsurgery. The Verlagsgesellschaft fine-tuned the written
textbookpresented here aimsnotonlyto pro- material and the various pictures into a book
vide a more complete overview ofdiseasesof and I am gratefulfor her professionalskill.
the ear, nose, throat, and tracheobronchialtree I hope thatreaderswillfind thisa pleasant
butalso to increase understanding ofthe func- and usefulbookand thatinterestin thisfield
tionsofthe respective organsfor hearing, olfac- will continue to develop the science of ear,
tion, swallowing, vocalization, and condition- nose, throat, and tracheobronchialdiseasesin
ing inspired air for gasexchange in the lung. dogsand cats.
Each chapter beginswith functionalconsid-
erationsofitssubjectand endswith a clinical
topicchosen for itsuncommon complexity. The
book is readily accessible through a detailed Utrecht, May2005
list of contents and an elaborate index. It is Anjop Venker-van Haagen
Cat. China, second half
of the 18th century. Cat
showssignsof severe
dyspnea: mouth breath-
ing and fear.
(From: Rijksmuseum,
Diary1999, week44,
with permission).
IX