I. Khelik and N. Di Girolamo
Background:
Nasopharyngeal stenosis is well-recognized in cats and guinea pigs but had not been previously reported in rabbits. This case report describes a unique occurrence of acquired nasopharyngeal stenosis in a pet rabbit, complicated by chronic displacement of the epiglottis. The goal was to document the diagnosis and successful treatment of this condition using fluoroscopic balloon dilation.
Methods:
A 4-year-old neutered male Dutch rabbit with chronic upper respiratory signs underwent a series of diagnostic evaluations, including CT imaging, endoscopy, and airway fluoroscopy, confirming nasopharyngeal stenosis and epiglottic displacement. Over time, three fluoroscopic balloon dilation procedures were performed to relieve the obstruction. The procedures involved balloon placement via a guide wire under general anesthesia, with dilation at three sites per session, and intermittent administration of corticosteroids and contrast medium.
Results:
The rabbit showed progressive clinical improvement across the three dilation sessions, with resolution of nasal discharge, reduced respiratory stertor, and eventual repositioning of the epiglottis to its physiological state. Follow-up at 18 months post-treatment confirmed the rabbit remained healthy without recurrence of respiratory signs.
Limitations:
As a single case report, findings cannot be generalized. The precise cause of the stenosis remains unclear, and while Pasteurella multocida was cultured, causality was not established. The interpretation of imaging findings and procedural outcomes is inherently subjective and limited by lack of control cases.
Conclusions:
This report documents the first known case of nasopharyngeal stenosis in a rabbit, successfully treated with fluoroscopic balloon dilation. The approach was minimally invasive and led to long-term resolution. This technique may offer a viable treatment for similar conditions in rabbits and other small mammals, broadening the therapeutic options for complex respiratory obstructions.
Computed tomographic (CT) findings in the rabbit from this report compared with a rabbit imaged for a different condition and having a normalpharynx. (A) Sagittal plane CT image of the rabbit from this report showing thickening of the retropharyngeal soft tissues and thickening of the softpalate, with contact of the caudalmost portion of the soft palate (asterisk) with the dorsal wall of the pharynx (arrow) and obliteration of the gas fillednasopharynx. The yellow line shows the approximate level of the transverse plane image in B. (B) Transverse plane CT image of the rabbit from thisreport showing severe narrowing of the airway in the caudal region of the nasopharynx (arrow). (C) Sagittal plane CT image of a representative rabbitwith normal pharynx. The yellow line shows the approximate level of the transverse plane image in D. (D) Transverse plane CT image showing thenormal appearance and diameter of the airway caudal to the free margin of the soft palate.
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