Treatment of Sinonasal Aspergillosis by Debridement and Sinonasal Deposition Therapy with Clotrimazole Under Rhinoscopic Guidance.

Rhinoscopy was performed on 10 dogs with sinonasal aspergillosis (SNA). Direct access to the sinus via the nasal ostium was possible with a flexible endoscope to allow sinuscopy. Debridement of fungal plaques in the frontal sinus and the nasal cavity was performed, and a sinus and nasal deposition therapy with clotrimazole (1%) cream was made under rhinoscopic guidance. No oral medication was administered following the procedure. A rhinoscopic follow-up was performed monthly until cure. Six of ten (60%) dogs presented fungal plaques in the nasal cavity and in the frontal sinus and 4/10 (40%) dogs presented fungal plaques only in the frontal sinus. Five of ten (50%) dogs were considered to be cured at the first follow-up rhinoscopy, 4/10 (40%) after the second follow-up, and 1/10 (10%) after the third. Two dogs had delayed recurrence of SNA rhinoscopically assessed 12 and 21 mo, respectively, after the last clotrimazole treatment. Endoscopic debridement of fungal plaques and clotrimazole (1%) cream deposition therapy seems to be a valuable minimally invasive technique for SNA treatment in dogs without the use of complementary oral medication. Delayed recurrence is a potential finding following treatment of SNA.