Fluoroscopic-assisted transesophageal retrograde nasopharyngoscopy in dogs and cats

Abstract

Objective: To devise a safe and effective method for accessing the nasopharynx (NP) in dogs and cats with complex or challenging disorders such as choanal tumors or entrapped foreign material. Animals: Dogs and cats. Methods: The patient is placed under general anesthesia and positioned in right lateral recumbency; the left cervical region over the proximal esophagus is then clipped and aseptically prepared. A guidewire is directed via the nostril into the oropharynx. The tip of the wire is retrieved and secured with a surgical clamp, which is then advanced into the proximal esophagus. A sterile assistant makes a small incision over the clamp, allowing the wire to be pulled out through the neck. A 20F or 26F peel-away sheath with introducer is directed over the wire into the NP. The introducer is removed, and a flexible endoscope is directed through the sheath into the NP. At the end of the intervention, a 14F or 18F feeding tube is placed through the esophageal stoma to promote healing and reduce the risk of abscessation; the feeding tube is removed after 2 weeks. Results: Fluoroscopic-assisted retrograde transesophageal nasopharyngoscopy provides superior visualization and access to the NP. Clinical Relevance: The method described here provides excellent access to the NP and is a useful option for the management of complex or challenging NP or choanal disease in companion animals.