{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T17:12:29Z","timestamp":1761066749312,"version":"build-2065373602"},"reference-count":27,"publisher":"American Veterinary Medical Association (AVMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2025,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>Objective<\/jats:title>\n<jats:p>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). <\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Animals<\/jats:title>\n<jats:p>18 client-owned dogs.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Clinical Presentation<\/jats:title>\n<jats:p>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. <\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>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\u00b0 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. <\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Clinical Relevance<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.25.04.0266","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T17:25:40Z","timestamp":1754673940000},"page":"1-7","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes in dogs with sinonasal aspergillosis treated via sinuscopic debridement and clotrimazole cream application"],"prefix":"10.2460","volume":"263","author":[{"given":"Beatrice","family":"Hertel","sequence":"first","affiliation":[{"name":"Surgery Department, San Marco Veterinary Clinic and Laboratory, Veggiano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frances","family":"Bird","sequence":"additional","affiliation":[{"name":"Surgery Department, Pride Veterinary Referrals, Derby, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Vallefuoco","sequence":"additional","affiliation":[{"name":"Surgery Department, Pride Veterinary Referrals, Derby, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Longley","sequence":"additional","affiliation":[{"name":"Surgery Department, Pride Veterinary Referrals, Derby, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herv\u00e9","family":"Brissot","sequence":"additional","affiliation":[{"name":"Surgery Department, AzurVet, Saint-Laurent-du-Var, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"issue":"10","key":"ref1","series-title":"J Small Anim Pract","first-page":"513","article-title":"Treatment of canine nasal aspergillosis\/penicilliosis with fluconazole","volume":"32","author":"Sharp NJH","year":"1991","unstructured":"Sharp NJH, Harvey CE, O\u2019Brien JA Treatment of canine nasal aspergillosis\/penicilliosis with fluconazole. J Small Anim Pract. 1991;32(10):513-516. doi:10.1111\/j.1748-5827.1991.tb00868.x"},{"issue":"5","key":"ref2","series-title":"Vet Clin North Am Small Anim Pract","first-page":"901","article-title":"Update on canine sinonasal aspergillosis","volume":"37","author":"Peeters D","year":"2007","unstructured":"Peeters D, Clercx C Update on canine sinonasal aspergillosis. Vet Clin North Am Small Anim Pract. 2007;37(5):901-916, vi. doi:10.1016\/j.cvsm.2007.05.005"},{"issue":"8","key":"ref3","series-title":"J Small Anim Pract","first-page":"434","article-title":"Sinonasal aspergillosis in dogs: a review","volume":"53","author":"Sharman MJ","year":"2012","unstructured":"Sharman MJ, Mansfield CS Sinonasal aspergillosis in dogs: a review. J Small Anim Pract. 2012;53(8):434-444. doi:10.1111\/j.1748-5827.2012.01245.x"},{"issue":"9","key":"ref4","series-title":"J Small Anim Pract","first-page":"504","article-title":"Treatment of refractory sino-nasal aspergillosis with posaconazole and terbinafine in 10 dogs","volume":"58","author":"Stewart J","year":"2017","unstructured":"Stewart J, Bianco D Treatment of refractory sino-nasal aspergillosis with posaconazole and terbinafine in 10 dogs. J Small Anim Pract. 2017;58(9):504-509. doi:10.1111\/jsap.12686"},{"issue":"7","key":"ref5","series-title":"J Small Anim Pract","first-page":"411","article-title":"Treatment of canine sinonasal aspergillosis with clotrimazole infusion in patients with cribriform plate lysis","volume":"59","author":"Stanton JA","year":"2018","unstructured":"Stanton JA, Miller ML, Johnson P, Davignon DL, Barr SC Treatment of canine sinonasal aspergillosis with clotrimazole infusion in patients with cribriform plate lysis. J Small Anim Pract. 2018;59(7):411-414. doi:10.1111\/jsap.12835"},{"issue":"2","key":"ref6","series-title":"J Am Anim Hosp Assoc","first-page":"103","article-title":"Treatment of sinonasal aspergillosis by debridement and sinonasal deposition therapy with clotrimazole under rhinoscopic guidance","volume":"54","author":"Vedrine B","year":"2018","unstructured":"Vedrine B, Fribourg-Blanc LA Treatment of sinonasal aspergillosis by debridement and sinonasal deposition therapy with clotrimazole under rhinoscopic guidance. J Am Anim Hosp Assoc. 2018;54(2):103-110. doi:10.5326\/JAAHA-MS-6648"},{"issue":"6","key":"ref7","series-title":"J Small Anim Pract","first-page":"312","article-title":"Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis","volume":"47","author":"Sissener TR","year":"2006","unstructured":"Sissener TR, Bacon NJ, Friend E, Anderson DM, White RA Combined clotrimazole irrigation and depot therapy for canine nasal aspergillosis. J Small Anim Pract. 2006;47(6):312-315. doi:10.1111\/j.1748-5827.2006.00017.x"},{"issue":"1","key":"ref8","series-title":"J Am Anim Hosp Assoc","first-page":"33","article-title":"Long-term outcomes in dogs with sinonasal aspergillosis treated with intranasal infusions of enilconazole","volume":"43","author":"Schuller S","year":"2007","unstructured":"Schuller S, Clercx C Long-term outcomes in dogs with sinonasal aspergillosis treated with intranasal infusions of enilconazole. J Am Anim Hosp Assoc. 2007;43(1):33-38. doi:10.5326\/0430033"},{"issue":"3","key":"ref9","series-title":"Vet Surg","first-page":"322","article-title":"Trephination of the frontal sinuses and instillation of clotrimazole cream: a computed tomographic study in canine cadavers","volume":"42","author":"Burrow R","year":"2013","unstructured":"Burrow R, Baker M, White L, McConnell JF Trephination of the frontal sinuses and instillation of clotrimazole cream: a computed tomographic study in canine cadavers. Vet Surg. 2013;42(3):322-328. doi:10.1111\/j.1532-950X.2013.01105.x"},{"issue":"4","key":"ref10","series-title":"J Comp Pathol","first-page":"283","article-title":"An immunohistochemical study of canine nasal aspergillosis","volume":"132","author":"Peeters D","year":"2005","unstructured":"Peeters D, Day MJ, Clercx C An immunohistochemical study of canine nasal aspergillosis. J Comp Pathol. 2005;132(4):283-288. doi:10.1016\/j.jcpa.2004.11.002"},{"issue":"4","key":"ref11","series-title":"Vet Radiol Ultrasound","first-page":"414","article-title":"Comparison of radiography and computed tomography for the diagnosis of canine nasal aspergillosis","volume":"44","author":"Saunders JH","year":"2003","unstructured":"Saunders JH, van Bree H. Comparison of radiography and computed tomography for the diagnosis of canine nasal aspergillosis. Vet Radiol Ultrasound. 2003;44(4):414-419. doi:10.1111\/j.1740-8261.2003.tb00478.x"},{"issue":"5","key":"ref12","series-title":"J Am Vet Med Assoc","first-page":"738","article-title":"Results of rhinoscopy alone or in conjunction with sinuscopy in dogs with aspergillosis: 46 cases (2001-2004)","volume":"228","author":"Johnson LR","year":"2006","unstructured":"Johnson LR, Drazenovich TL, Herrera MA, Wisner ER Results of rhinoscopy alone or in conjunction with sinuscopy in dogs with aspergillosis: 46 cases (2001-2004). J Am Vet Med Assoc. 2006;228(5):738-742. doi:10.2460\/javma.228.5.738"},{"issue":"2","key":"ref13","series-title":"J Small Anim Pract","first-page":"67","article-title":"Effect of sampling method and incubation temperature on fungal culture in canine sinonasal aspergillosis","volume":"50","author":"Billen F","year":"2009","unstructured":"Billen F, Clercx C, Le Gar\u00e9rr\u00e8s A, Massart L, Mignon B, Peeters D Effect of sampling method and incubation temperature on fungal culture in canine sinonasal aspergillosis. J Small Anim Pract. 2009;50(2):67-72. doi:10.1111\/j.1748-5827.2008.00672.x"},{"issue":"6","key":"ref14","series-title":"J Small Anim Pract","first-page":"320","article-title":"Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole","volume":"47","author":"Claeys S","year":"2006","unstructured":"Claeys S, Lefebvre JB, Schuller S, Hamaide A, Clercx C Surgical treatment of canine nasal aspergillosis by rhinotomy combined with enilconazole infusion and oral itraconazole. J Small Anim Pract. 2006;47(6):320-324. doi:10.1111\/j.1748-5827.2006.00154.x"},{"issue":"8","key":"ref15","series-title":"J Small Anim Pract","first-page":"423","article-title":"Multi-centre assessment of mycotic rhinosinusitis in dogs: a retrospective study of initial treatment success (1998 to 2008)","volume":"51","author":"Sharman M","year":"2010","unstructured":"Sharman M, Paul A, Davies D,  Multi-centre assessment of mycotic rhinosinusitis in dogs: a retrospective study of initial treatment success (1998 to 2008). J Small Anim Pract. 2010;51(8):423-427. doi:10.1111\/j.1748-5827.2010.00957.x"},{"issue":"1","key":"ref16","series-title":"J Vet Intern Med","first-page":"40","article-title":"Treatment of canine nasal aspergillosis with enilconazole","volume":"7","author":"Sharp NJ","year":"1993","unstructured":"Sharp NJ, Sullivan M, Harvey CE, Webb T Treatment of canine nasal aspergillosis with enilconazole. J Vet Intern Med. 1993;7(1):40-43. doi:10.1111\/j.1939-1676.1993.tb03167.x"},{"issue":"4","key":"ref17","series-title":"Otolaryngol Head Neck Surg","first-page":"372","article-title":"Classification of fungal sinusitis in immunocompetent patients","volume":"129","author":"Uri N","year":"2003","unstructured":"Uri N, Cohen-Kerem R, Elmalah I, Doweck I, Greenberg E Classification of fungal sinusitis in immunocompetent patients. Otolaryngol Head Neck Surg. 2003;129(4):372-378. doi:10.1016\/S0194-59980301304-4"},{"issue":"2","key":"ref18","series-title":"Otolaryngol Clin North Am","first-page":"375","article-title":"Chronic invasive fungal rhinosinusitis","volume":"33","author":"Stringer SP","year":"2000","unstructured":"Stringer SP, Ryan MW Chronic invasive fungal rhinosinusitis. Otolaryngol Clin North Am. 2000;33(2):375-387. doi:10.1016\/S0030-6665(00)80012-2"},{"issue":"6","key":"ref19","series-title":"J Vet Intern Med","first-page":"2069","article-title":"Minimally invasive treatment of sino-nasal aspergillosis in dogs","volume":"32","author":"Ballber C","year":"2018","unstructured":"Ballber C, Hill TL, Bommer NX Minimally invasive treatment of sino-nasal aspergillosis in dogs. J Vet Intern Med. 2018;32(6):2069-2073. doi:10.1111\/jvim.15311"},{"issue":"3","key":"ref20","series-title":"J Small Anim Pract","first-page":"161","article-title":"Clotrimazole and enilconazole distribution within the frontal sinuses and nasal cavity of nine dogs with sinonasal aspergillosis","volume":"53","author":"Sharman M","year":"2012","unstructured":"Sharman M, Lenard Z, Hosgood G, Mansfield C Clotrimazole and enilconazole distribution within the frontal sinuses and nasal cavity of nine dogs with sinonasal aspergillosis. J Small Anim Pract. 2012;53(3):161-167. doi:10.1111\/j.1748-5827.2011.01181.x"},{"issue":"6","key":"ref21","series-title":"Vet Surg","first-page":"508","article-title":"Endoscopic examination and treatment of paranasal sinus disease in 16 horses","volume":"22","author":"Ruggles AJ","year":"1993","unstructured":"Ruggles AJ, Ross MW, Freeman DE Endoscopic examination and treatment of paranasal sinus disease in 16 horses. Vet Surg. 1993;22(6):508-514. doi:10.1111\/j.1532-950X.1993.tb00429.x"},{"issue":"12","key":"ref22","series-title":"J Small Anim Pract","first-page":"777","article-title":"Comparison of two minimally invasive enilconazole perendoscopic infusion protocols for the treatment of canine sinonasal aspergillosis","volume":"59","author":"Vangrinsven E","year":"2018","unstructured":"Vangrinsven E, Girod M, Goossens D, Desquilbet L, Clercx C, Billen F Comparison of two minimally invasive enilconazole perendoscopic infusion protocols for the treatment of canine sinonasal aspergillosis. J Small Anim Pract. 2018;59(12):777-782. doi:10.1111\/jsap.12933"},{"issue":"1","key":"ref23","series-title":"Vet Radiol Ultrasound","first-page":"5","article-title":"Computed tomographic findings in 35 dogs with nasal aspergillosis","volume":"43","author":"Saunders JH","year":"2002","unstructured":"Saunders JH, Zonderland JL, Clercx C,  Computed tomographic findings in 35 dogs with nasal aspergillosis. Vet Radiol Ultrasound. 2002;43(1):5-9. doi:10.1111\/j.1740-8261.2002.tb00434.x"},{"issue":"2","key":"ref24","series-title":"Sabouraudia","first-page":"158","article-title":"Mode of action of clotrimazole","volume":"11","author":"Iwata K","year":"1973","unstructured":"Iwata K, Yamaguchi H, Hiratani T Mode of action of clotrimazole. Sabouraudia. 1973;11(2):158-166. doi:10.1080\/00362177385190321"},{"issue":"2","key":"ref25","series-title":"J Small Anim Pract","first-page":"95","article-title":"Distribution and persistence of topical clotrimazole after sinus infusion in normal canine cadavers","volume":"53","author":"Hayes GM","year":"2012","unstructured":"Hayes GM, Demetriou JL Distribution and persistence of topical clotrimazole after sinus infusion in normal canine cadavers. J Small Anim Pract. 2012;53(2):95-100. doi:10.1111\/j.1748-5827.2011.01164.x"},{"issue":"7","key":"ref26","series-title":"J Am Vet Med Assoc","first-page":"757","article-title":"Repeated rhinoscopic and serologic assessment of the effectiveness of intranasally administered clotrimazole for the treatment of nasal aspergillosis in dogs","volume":"236","author":"Pomrantz JS","year":"2010","unstructured":"Pomrantz JS, Johnson LR Repeated rhinoscopic and serologic assessment of the effectiveness of intranasally administered clotrimazole for the treatment of nasal aspergillosis in dogs. J Am Vet Med Assoc. 2010;236(7):757-762. doi:10.2460\/javma.236.7.757"},{"issue":"4","key":"ref27","series-title":"J Am Vet Med Assoc","first-page":"501","article-title":"Comparison of topical administration of clotrimazole through surgically placed versus nonsurgically placed catheters for treatment of nasal aspergillosis in dogs: 60 cases (1990-1996)","volume":"213","author":"Mathews KG","year":"1998","unstructured":"Mathews KG, Davidson AP, Koblik PD,  Comparison of topical administration of clotrimazole through surgically placed versus nonsurgically placed catheters for treatment of nasal aspergillosis in dogs: 60 cases (1990-1996). J Am Vet Med Assoc. 1998;213(4):501-506. doi:10.2460\/javma.1998.213.04.501"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/11\/javma.25.04.0266.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/11\/javma.25.04.0266.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/javma\/263\/11\/javma.25.04.0266.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:34:29Z","timestamp":1761064469000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/263\/11\/javma.25.04.0266.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,1]]},"references-count":27,"journal-issue":{"issue":"11"},"URL":"https:\/\/doi.org\/10.2460\/javma.25.04.0266","relation":{},"ISSN":["0003-1488"],"issn-type":[{"type":"print","value":"0003-1488"}],"subject":[],"published":{"date-parts":[[2025,11,1]]}}}