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Case Reports
. 2022 Nov;63(11):1119-1123.

Reverse sneezing as a clinical manifestation of nasopharyngeal-oropharyngeal fistula in a dog

Marianthi Gelatos  1 , Sara A Colopy  1 , Kenneth Waller  1 , Jessica C Pritchard  1
Affiliations
Case Reports

Reverse sneezing as a clinical manifestation of nasopharyngeal-oropharyngeal fistula in a dog

Marianthi Gelatos et al. Can Vet J. 2022 Nov.

Abstract
in English, French

A 6-year-old spayed female Labrador retriever was evaluated for a 3-month history of intermittent reverse sneezing and gagging episodes. Pertinent findings at evaluation included frequent reverse sneezing and non-productive retching. No pathology was visible on sedated oral examination. Contrast-enhanced computed tomography of the skull revealed a gas-filled defect within the left ventral aspect of the soft palate. A non-eroded defect was present in the left caudoventral nasopharyngeal wall on nasopharyngoscopy. Surgical exploration revealed a nasopharyngeal-oropharyngeal fistula within the left palatine tonsillar fossa. The dog had a witnessed oropharyngeal stick injury (OSI) 3 months previous in the location of the fistula. The OSI had been allowed to heal by secondary intention and was treated with an oral antibiotic and NSAID. However, the dog lacked characteristic signs of a chronic OSI such as nasal discharge or abscess formation. The defect in the soft palate was surgically debrided and closed, and the left palatine tonsil was excised. The dog recovered completely with cessation of reverse sneezing and retching episodes.

Éternuements inversés comme manifestation clinique d’une fistule oropharyngée-nasopharyngée chez un chien. Une femelle Labrador stérilisée âgée de 6 ans a été évaluée pour une histoire de 3 mois d’épisodes intermittents d’éternuements inversés et d’étouffements. Les résultats pertinents lors de l’évaluation comprenaient des éternuements inversés fréquents et des haut-le-coeur non productifs. Aucune pathologie n’était visible à l’examen oral sous sédation. La tomodensitométrie à contraste amélioré du crâne a révélé une imperfection remplie de gaz dans la face ventrale gauche du palais mou. Une imperfection non érodée était présente dans la paroi nasopharyngée caudo-ventrale gauche à la nasopharyngoscopie. L’exploration chirurgicale a révélé une fistule nasopharyngée-oropharyngée au sein de la fosse amygdalienne palatine gauche. Le chien a eu une blessure oropharyngée par une branche (OSI) il y a 3 mois à l’emplacement de la fistule. L’OSI avait été laissée à guérir par seconde intention et a été traitée avec un antibiotique oral et un AINS. Cependant, le chien ne présentait pas de signes caractéristiques d’une OSI chronique comme un écoulement nasal ou la formation d’abcès. Le défaut du palais mou a été chirurgicalement débridé et fermé, et l’amygdale palatine gauche a été excisée. Le chien s’est complètement rétabli avec l’arrêt des épisodes d’éternuements inversés et de haut-le-coeur.(Traduit par Dr Serge Messier).

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Figures

Figure 1
Figure 1
Contrast-enhanced and plain computed tomography (CT), transverse plane; right to left. A — At the level of the cone-shaped gas containing defect in the left dorsolateral soft palate (white arrow). B — A clinically normal patient at approximately the same anatomic location, with a smooth typical ovoid shape to the nasopharynx.
Figure 2
Figure 2
Retroflexed nasopharyngoscopy image of the reported dog’s nasopharynx (*) and defect in the left ventrolateral nasopharyngeal wall (^).
Figure 3
Figure 3
Images of the dog’s oral cavity with the patient in dorsal recumbency under general anesthesia. A — A 20-gauge IV catheter is passed through nasopharyngeal-oropharyngeal fistula noted in left palatine tonsillar fossa. B — The nasopharyngeal-oropharyngeal fistula, as well as adjacent left palatine tonsil after surgical debridement. C — Sutures in the place of the previous nasopharyngeal-oropharyngeal fistula following surgical repair.
See this image and copyright information in PMC

References

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