To analyze the results of transoral ventral bulla osteotomy (TOVBO) in cats.
13 client-owned cats treated by TOVBO between February 2016 and February 2019.
Medical records of cats with a diagnosis of middle ear disease (MED) that underwent TOVBO were reviewed. The procedure was similar to the one described for dogs. Short-term follow-up was obtained via clinical examination before discharge and at day 15 postoperatively. Long-term follow-up was performed via telephone interview.
13 cats (age range, 8 months to 12 years) underwent unilateral (n = 10) or bilateral (3) TOVBO (16) for the treatment of tympanic bulla (TB) infection (10), nasopharyngeal inflammatory polyps (5), or bullet retrieval from the TB (1). There were no intraoperative complications. One cat with a poor preoperative status died at postoperative day 3 from pneumonia. Eight cats experienced postoperative complications including head tilt (n = 2), Horner syndrome (3), loss of appetite (2), and temporary blindness (1). Collected samples confirmed the presence of nasopharyngeal inflammatory polyps (5), or otitis media (8). Six months after surgical intervention, 9 cats were free of MED signs.
This oral approach provided a good access to the TB in all cases. The complications observed after TOVBO were similar to those for VBO. In cats, TOVBO seems to be an acceptable and safe minimally invasive alternative to the other approaches of the TB to address MED.
CASE DESCRIPTION A 10-year-old spayed female Rottweiler was referred for evaluation because of a 2-month history of regurgitation and weight loss, despite no apparent change in appetite. The dog had received antiemetic and antacid treatment, without improvement.
CLINICAL FINDINGS Physical examination revealed a low body condition score (2/5), but other findings were unremarkable. Diffuse, global esophageal dilatation was noted on plain thoracic radiographs, and normal motility was confirmed through videofluoroscopic evaluation of swallowing. Transhepatic ultrasonographic and CT examination revealed a circumferential, intraparietal lesion in the distal portion of the esophagus causing distal esophageal or cardial subobstruction and no metastases. Incisional biopsy of the lesion was performed, and findings of histologic examination supported a diagnosis of esophageal leiomyoma.
TREATMENT AND OUTCOME In view of numerous possible complications associated with esophageal surgery, the decision was made to palliatively treat the dog by transcardial placement of a self-expanding, covered, nitinol esophageal stent under endoscopic guidance. Two weeks after stent placement, radiography revealed complete migration of the stent into the gastric lumen. Gastrotomy was performed, and the stent was replaced and fixed in place. Twenty-four months after initial stent placement, the dog had a healthy body condition and remained free of previous clinical signs.
CLINICAL RELEVANCE Diffuse benign muscular neoplasia should be considered as a differential diagnosis for acquired esophageal dilatation in adult and elderly dogs. In the dog of this report, transcardial stent placement resulted in resolution of the clinical signs, with no apparent adverse effect on digestive function. The described procedure could be beneficial for nonsurgical treatment of benign esophageal tumors in dogs.