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Bilateral pararhinotomy with middle meatal antrostomy of the maxillary sinus in a rabbit (Oryctolagus cuniculus) with chronic rhinitis

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  • 1 1William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 2 2Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 3Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Abstract

CASE DESCRIPTION

A 4-year-old spayed female mixed-breed rabbit was evaluated because of a 3-year history of sneezing and nasal discharge that were refractory to medical management.

CLINICAL FINDINGS

Signs of chronic left-sided rhinitis and sinusitis were observed on physical examination and confirmed by CT evaluation. Lysis of the rostral aspect of the left maxillary bone and destruction of nasal turbinates were evident on CT images.

TREATMENT AND OUTCOME

Pararhinotomy of the left maxillary sinus through the facies cribrosa was performed. Purulent material was removed from the maxillary sinus recesses, a middle meatal antrostomy was completed to allow permanent drainage into the left middle nasal meatus, and the tissues were closed routinely. Microbial culture of a sample from the maxillary sinus recesses revealed Bordetella bronchiseptica, undetermined fastidious nonenteric bacteria, and Streptococcus viridans. Medical management was continued, and nasal discharge resolved but sneezing persisted. Increased sneezing and bilateral nasal discharge developed 1.5 years later; CT examination revealed right-sided rhinitis, and culture of a nasal swab sample revealed Bordetella spp, Staphylococcus spp, and Micrococcus spp. Right-sided pararhinotomy and middle meatal antrostomy were performed, and medical management continued. A subsequent recurrence was managed without additional surgery; 4 years after the initial surgery, the rabbit was still receiving medical treatment, with mild intermittent nasal discharge and sneezing reported.

CLINICAL RELEVANCE

This report describes a surgical approach for treatment of chronic rhinitis in companion rabbits with maxillary sinus involvement that included creation of a permanent drainage pathway from the maxillary sinus to the middle nasal meatus.

Abstract

CASE DESCRIPTION

A 4-year-old spayed female mixed-breed rabbit was evaluated because of a 3-year history of sneezing and nasal discharge that were refractory to medical management.

CLINICAL FINDINGS

Signs of chronic left-sided rhinitis and sinusitis were observed on physical examination and confirmed by CT evaluation. Lysis of the rostral aspect of the left maxillary bone and destruction of nasal turbinates were evident on CT images.

TREATMENT AND OUTCOME

Pararhinotomy of the left maxillary sinus through the facies cribrosa was performed. Purulent material was removed from the maxillary sinus recesses, a middle meatal antrostomy was completed to allow permanent drainage into the left middle nasal meatus, and the tissues were closed routinely. Microbial culture of a sample from the maxillary sinus recesses revealed Bordetella bronchiseptica, undetermined fastidious nonenteric bacteria, and Streptococcus viridans. Medical management was continued, and nasal discharge resolved but sneezing persisted. Increased sneezing and bilateral nasal discharge developed 1.5 years later; CT examination revealed right-sided rhinitis, and culture of a nasal swab sample revealed Bordetella spp, Staphylococcus spp, and Micrococcus spp. Right-sided pararhinotomy and middle meatal antrostomy were performed, and medical management continued. A subsequent recurrence was managed without additional surgery; 4 years after the initial surgery, the rabbit was still receiving medical treatment, with mild intermittent nasal discharge and sneezing reported.

CLINICAL RELEVANCE

This report describes a surgical approach for treatment of chronic rhinitis in companion rabbits with maxillary sinus involvement that included creation of a permanent drainage pathway from the maxillary sinus to the middle nasal meatus.

Contributor Notes

Dr. Summa's present address is Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, St-Hyacinthe, QC J2S 2M2, Canada.

Dr. Keller's present address is Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Dr. Wood's present address is Colorado Veterinary Specialists & Animal ER, 221 W County Line Rd, Littleton, CO 80129.

Address correspondence to Dr. Sanchez-Migallon Guzman (guzman@ucdavis.edu).