Use of a novel surgical approach for treatment of complete bilateral membranous choanal atresia in an alpaca cria

Abstract

A 6.3-kg (13.9-lb) 4-hour-old female Huacaya alpaca cria, accompanied by its dam, was admitted to a veterinary medical teaching hospital because of respiratory distress and difficulty nursing since birth (day 0). On admission, the cria was bright, alert, and responsive; it was able to stand on its own, and had a suckle reflex. The cria was tachycardic (heart rate, 160 beats/min) and had open-mouth breathing (80 breaths/min); its rectal temperature was within the reference range at 37.5°C (99.5°F). The oral mucous membranes were cyanotic, and no airflow could be detected from either nostril during expiration. Introduction of a 5F flexible red rubber tube into the ventral meatus of each nostril revealed the lack of patency of either of the choanae. On the basis of these findings, a presumptive diagnosis of congenital complete bilateral choanal atresia was made. Evaluation of the head by CT was recommended to confirm the diagnosis and determine the type of choanal obstruction.Supplemental oxygen delivery was initiated via face mask at a rate of 5 L/min. The patient was anesthetized and intubated orotracheally, and CT images

Choanenatresie bei einem Alpakacria (Vicugna pacos)

“…Auch bei diesem Fall kam es zu postoperativen Komplikationen durch ein Zusetzen der Stents mit Sekret sowie durch eine Aspirationspneumonie. Die Stents konnten ebenfalls nach 2 Wochen entfernt werden und bei telefonischen Nachkontrollen war das Tier laut Besitzer klinisch gesund [31]. Während und nach der Operation sollte eine Schmerztherapie erfolgen.…”

“…Die Autoren schildern jedoch auch eine notwendige tägliche Reinigung der Stents 30 . Pader et al 31 nutzten eine endoskopisch gestützte Ballondilationstechnik und das Einsetzen von Nasenstents zur chirurgischen Therapie eines neonatalen Alpakas mit bilateraler Choanenatresie. Auch bei diesem Fall kam es zu postoperativen Komplikationen durch ein Zusetzen der Stents mit Sekret sowie durch eine Aspirationspneumonie.…”

Successful treatment of a dog with recurrent nasopharyngeal stenosis using balloon dilation and a novel topical mitomycin delivery system

“…Treatments include balloon dilation,4 5 surgical resection6 or placement of an expandable stent across the area1–3; however, such treatments can result in recurrent stenosis, infection or other complications such as palatal erosion and oronasal fistulation 1–5 7. Topical mitomycin has been used as part of a treatment regimen for nasopharyngeal stenosis in a dog,2 4 a cria8 and in human beings,9 and bilateral choanal atresia in a foal,10 and for prevention of experimentally induced glottic stenosis in dogs 11. This case report describes the clinical presentation, imaging, treatment and follow‐up of a dog with recurrent, acquired nasopharyngeal stenosis that was successfully treated with balloon dilation and topical mitomycin therapy.…”