Nasopharyngeal stenosis in cats-what are the types?

January 13, 2025

L. Mestrinho, R. Fonseca

Background
Nasopharyngeal stenosis (NPS) in cats, encompassing congenital (e.g., choanal atresia) and acquired forms, causes partial or complete occlusion of the nasopharyngeal passage. This study aimed to characterise NPS features using computed tomography (CT), evaluate associated anomalies, and distinguish NPS from choanal atresia.

Methods
A retrospective, cross-sectional study included 43 cats: 23 cases with NPS and 20 controls. Inclusion required full-head CT scans and clinical records; brachycephalic breeds, head trauma, and neoplasms were excluded. Data included anatomical features, soft palate anomalies, and tympanic bulla abnormalities. Statistical analysis employed Fisher’s exact test and other parametric/non-parametric methods.

Results
-Cats with NPS were younger (mean age 3.30 years) than controls (mean age 7.62 years, p < 0.001).
-NPS presented as thin nasopharyngeal membranes, soft palate adhesions, or imperforate nasopharynx (11/23 cases).
-Associated anomalies included paranasal sinus changes (significant sphenoid sinus lysis, p = 0.002), tympanic bulla soft tissue attenuation, and shorter soft palates in NPS cases (mean 34.67 mm vs. 41.02 mm in controls, p = 0.008).
-Nasal obstruction and tympanic bulla anomalies were significantly linked to imperforate membranes (p = 0.036).
-Comorbidities such as hiatal hernia and ventricular asymmetry were rare.

Limitations
-Small sample size limited subgroup analysis.
-Variability in endoscopy use might have led to underreporting of anomalies.
-Lack of longitudinal data restricted assessment of disease progression.

Conclusions
CT imaging revealed NPS as a heterogenous condition, with younger age and soft palate anomalies suggesting a congenital component. Imperforate membranes, combined with anatomical anomalies like bony bridges, were consistent with choanal atresia. These findings enhance the differentiation of congenital and acquired forms, aiding in diagnosis and surgical planning.

Computed tomographic images on the sagittal plane of four cats with different nasopharyngeal stenosis presentations, on bone window. (A)
Nasopharyngeal membrane, with the top arrow pointing to the stenosis and the bottom arrow indicating the soft palate; (B) adhesion of the soft
palate to the nasopharynx; (C) imperforated nasopharynx associated with an extensive soft palate adhesion; (D) imperforated nasopharynx associated
with the bony bridge

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