Caudal aberrant turbinate in a Pug with brachycephalic obstructive airway syndrome: a case report

Caudal aberrant turbinate is a relatively common turbinate bone anomaly in brachycephalic breeds with an undetermined etiology. This paper presents a 5-year-old Pug with a history of otitis media and interna, showing left ear discharge and respiratory distress. Radiography and advanced imaging, including computed tomography (CT) and magnetic resonance imaging (MRI), revealed bilateral otitis externa and media, an elongated and thickened soft palate, a narrowed nasopharynx, and caudal extension of bilateral turbinate structures into the nasopharynx. MRI also revealed left otitis interna. Twenty-six days later, the patient developed severe respiratory distress with radiographic signs of an increased caudodorsal lung opacity and gastric dilation, indicative of non-cardiogenic pulmonary edema from a chronic airway obstruction. Surgical treatment involved folded flap palatoplasty and left total ear canal ablation. Despite treatment, the dog expired due to the persistent respiratory distress. This case highlights that a caudal aberrant turbinate can contribute to airflow obstruction in brachycephalic obstructive airway syndrome (BOAS), particularly when compounded by other upper airway anomalies. CT imaging is valuable for identifying nasal structural abnormalities, including aberrant turbinates. Accordingly, an awareness of such anatomical variations is critical for the diagnosis and management of brachycephalic breeds presenting BOAS-related symptoms.