Regional Veterinary Surgery

Foreign bodies in the nasal cavity

FOREIGN BODY IN THE NASAL ACTIVITY

• Rostral turbinate system helps inthe filtering of direct entry of small foreign bodies and very rarely they get lodged in the nasal mucosa to cause inflammation.

 Clinical Signs

• Epistaxis
• Excessive sneezing
• Purulent discharge unilateral

Dignosis

• Direct visualization with magnification
• Otoscopy of the rostarl nasal passage.
• Radiography - plain and with contrast radiography

Treatment

• Removal of the foreign body depends on the space and location
• Rostral- use of a small alligator forceps along with endoscope.
• Caudal - may be embedded in the mucosa or free in the passage., use of a flexible endoscope
• Nasopharynx 2 - 4 mm diameter arthroscope  or in large dogs with a bronchoscope

Surgical approach

• Dorsal and ventral approach.
• Rhinotomy is the incision in to the nasal cavity

Dorsal approach

• Make a dorsal midline skin incision from the caudal aspect of the nasal septum to the medial canthus of the orbit. Explore both the sides of the nasal cavity.
• A bone saw can be used to elevate the periosteal flap on the proposed entry.
• Gently lavage the nasal passage and remove the foreign body. Bone flaps are sutured by 3-0 or 4-0 wire sutures. close the skin with apposition sutures.

Ventral approach

• Make a midline incision in the hard palate. Elevate the mucoperiostium, with out damaging the palatine vessels  and   nerves. Extend the incision caudally to the soft palate.
• Incise the palatine bone with rongeurs or power driven burr. Explore the nasal cavity.  After removing the foreign body Clsoe the nasal mucosa and oral mucosa with simple interruptted sutures.