Isolated Turbinectomy of Caudal Aberrant Turbinates in Brachycephalic Dogs

Malformed and hypertrophic turbinates blocking nasal airflow are a common problem in brachycephalic dogs. Many dogs also suffer from turbinates that grew retrograde into the meatus nasopharyngeus and even the nasopharynx, so called caudal aberrant turbinates (CATs). Reported prevalence of CATs in the literature ranges from 21% to 32% in brachycephalic dogs but is highly dependent on the breed. In pugs, up to 53% of the animals show CATs. Laser-assisted turbinectomy (LATE) has been shown to be able to remove the obstructing turbinates from the nasal cavity. However, some dogs with significant CATs show well-shaped intranasal turbinates at the same time. For these dogs, our goal was to develop a technique that retains intranasal turbinates, only removing caudal aberrant turbinates. Twenty-five brachycephalic dogs (24 pugs, 1 English bulldog) with CATs and proper air gaps between their intranasal turbinate branches were included in the study. An endoscopically guided diode laser fibre was used to dissect CATs. Xylometazoline was used in all dogs before surgery to shrink intranasal turbinates and make access to the CATs possible. Grasping forceps were used to extract the CAT after dissection. Thirty-five CATs were found in the 25 dogs. The origin was from the concha nasalis media (CNM) in 29 nasal cavities, from the third endoturbinale in 2, the concha nasalis ventralis (CNV) in 2 and from both, CNM and CNV in 2 cavities. Dissection was not possible with this technique for CATs deriving from the CNV so that a total of 32 CATs could be removed. In 28 nasal cavities, extraction was achieved with a grasping forceps from normograde. In 4 cavities size of the CAT prohibited this so they were pushed through the meatus nasopharyngeus into the nasopharynx and were extracted via the mouth. Minor bleeding was observed in 19 (54.4%) nasal cavities and was strong enough in one dog to impair visualisation so that the CAT could only be extracted one week later. Fourteen dogs (56%) had an endoscopic examination after 6 months in which complete healing and no signs of regrowth were observed in all dogs. Isolated CAT LATE is a viable method to remove CATs in dogs with non-obstructing intranasal turbinates and shows a low and only minor complication rate. It has the advantage of retaining intranasal turbinates in cases in which they are non-obstructing, therefore preserving their thermoregulatory capabilities. It is not suited for dogs with obviously obstructing intranasal turbinates.