Fluoroscopic-assisted transesophageal retrograde nasopharyngoscopy in dogs and cats

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.

Dogs and cats.

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.

Fluoroscopic-assisted retrograde transesophageal nasopharyngoscopy provides superior visualization and access to the NP.

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.