Outcomes in dogs with sinonasal aspergillosis treated via sinuscopic debridement and clotrimazole cream application.

Abstract

OBJECTIVE: To describe surgical fungal plaque debridement and clotrimazole 1% cream application via normograde sinoscopy (NS) and report short- and long-term outcomes in dogs with sinonasal aspergillosis (SNA). ANIMALS: 18 client-owned dogs. CLINICAL PRESENTATION: This was a retrospective single-institution case series of dogs diagnosed with SNA and treated with NS. Signalment, history, physical examination, diagnostic and sinuscopic findings, topical treatment frequency, complications, and outcome were recorded. RESULTS: 18 dogs underwent NS for SNA treatment. The median age was 8.5 years. Unilateral disease (15 of 18) was more frequent than bilateral. Following direct access to the frontal sinus, debridement of fungal plaques was completed under direct visualization with a 2.4-mm, 30° arthroscope. Two topical cream instillations were performed in 17 of 18 cases, with a complete resolution of clinical signs recorded in 15 of 18 dogs. Re-treatment was achieved via percutaneous injection in dogs requiring more than 1 topical cream application. A small self-limiting swelling of the surgical wound was reported in 1 case. Re-treatment via percutaneous injection was a fast, well-tolerated, and low-morbidity procedure. Repeated debridement via NS was required in 4 dogs. Long-term follow-up documented an overall cure rate of 83.3% with no major complications. CLINICAL RELEVANCE: NS provided a safe approach for complete debridement of the frontal sinus with a comparable outcome to previously reported treatments. No major complications associated with the surgical procedure occurred. This technique allowed direct visualization and video-assisted debridement of fungal plaques. Normograde sinoscopy could be considered as a technique to enhance topical treatments for extensive frontal sinus aspergillosis.