Nasopharyngeal Polyps in Cats: A Vet’s 2025 Guide to Recognition, Treatment & Care 🐾

Hi there! I’m Dr. Duncan Houston BVSc, veterinarian and founder of Ask A Vet. In this detailed 2025 guide, we explore nasopharyngeal polyps—benign inflammatory masses that often originate in the middle ear or eustachian tube and extend into the throat or ear canal. Awareness and prompt treatment can provide your cat with complete relief and minimize recurrence. Let's dive deep into signs, diagnosis, treatment options, and long‑term care:

📘 1. What Are Nasopharyngeal Polyps?

Polyps are non-cancerous, fleshy masses that form from inflamed tissue—typically in the middle ear (tympanic bulla), eustachian tube, or nasopharynx :contentReference[oaicite:3]{index=3}. These inflammatory growths are believed to be triggered by chronic ear or upper respiratory inflammation—often following viral or bacterial infections :contentReference[oaicite:4]{index=4}.

👶 2. Who Gets Them & Why It Matters

• Commonly seen in kittens and young cats under 2 years :contentReference[oaicite:5]{index=5}.
• No clear breed or sex predisposition—but often connected to chronic URI or ear inflammation :contentReference[oaicite:6]{index=6}.
• Though benign, polyps can obstruct the airway or ear canal, cause chronic infections, and affect quality of life.

👀 3. Typical Signs & Symptoms

Presentation depends on where the polyp extends:

• Noisy breathing (stertor), reverse sneezing, nasal congestion, difficulty swallowing or gagging because of nasopharyngeal obstruction :contentReference[oaicite:7]{index=7}.
• Ear involvement: head shaking, ear discharge, pawing, malodorous otitis externa :contentReference[oaicite:8]{index=8}.
• Neurological signs: head tilt, ataxia, nystagmus or Horner's syndrome due to extension into the middle or inner ear :contentReference[oaicite:9]{index=9}.
• Voice changes: altered vocalisation due to throat involvement :contentReference[oaicite:10]{index=10}.

🔬 4. Diagnostic Workup

1. Thorough exam: feline nasopharyngeal obstruction with stertor in a young cat is a classic sign :contentReference[oaicite:11]{index=11}.
2. Oral/pharyngeal inspection: sedation/anesthesia often needed. Soft-palate retraction or use of a spay-hook and flexible endoscope can visualize the polyp :contentReference[oaicite:12]{index=12}.
3. Otoscopic exam: check external ear canal and tympanic membrane :contentReference[oaicite:13]{index=13}.
4. Imaging: skull radiographs may reveal bulla changes; CT/MRI provides precise localization and surgical planning :contentReference[oaicite:14]{index=14}.
5. Definitive diagnosis: removal and histopathology confirm benign inflammatory nature :contentReference[oaicite:15]{index=15}.

🛠️ 5. Treatment Options

a) Traction & Avulsion

• Performed under general anesthesia: polyp is grasped beneath soft palate or through ear and gently removed :contentReference[oaicite:16]{index=16}.
• Follow-up with short course of systemic steroids and antibiotics helps reduce inflammation :contentReference[oaicite:17]{index=17}.
• Simple, minimally invasive—but recurrence occurs in ~15–50% of cases :contentReference[oaicite:18]{index=18}.

b) Ventral Bulla Osteotomy (VBO)

• Preferred when middle-ear involvement is suspected, or if recurrence happens :contentReference[oaicite:19]{index=19}.
• Surgeon creates opening in bulla to remove base/stalk—reducing recurrence risk :contentReference[oaicite:20]{index=20}.
• Best performed by boarded surgeon; potential transient side effects include Horner’s syndrome or balance disturbances :contentReference[oaicite:21]{index=21}.

📈 6. Prognosis & Recurrence

• After traction + medication: many cats improve initially but risk recurrence ranges 36–41% :contentReference[oaicite:22]{index=22}.
• Traction + steroids: combined approach may reduce recurrence (0% in a small study) :contentReference[oaicite:23]{index=23}.
• With VBO: recurrence is much lower; most cats resume normal lives after recovery :contentReference[oaicite:24]{index=24}.

🏡 7. Post-Surgical Care & Recovery

• Administer prescribed antibiotics and steroids to reduce inflammation.
• Monitor for Horner’s signs (ptosis, miosis, third eyelid elevation) and balance issues—often resolve in 4–6 weeks :contentReference[oaicite:25]{index=25}.
• Limit strenuous activity while healing; offer soft surfaces and rest.
• Schedule follow-up exams and, if needed, repeat imaging.
• Home monitoring via Ask A Vet app helps track breathing, eating, and neurological signs.

📚 8. Case Examples

“Milo,” an 8‑month‑old kitten, presented with noisy breathing and mild head tilt. On sedation, a pink polyp was visible behind the soft palate. Traction removal and a 2-week course of steroids restored normal breathing. Mild Horner’s resolved in 3 weeks, and no recurrence occurred at 1 year.

“Luna,” a 2‑year‑old with chronic sneezing and ear discharge, had recurrent polyps removed via ventral bulla osteotomy. Post‑surgery recovery included temporary ataxia and head tilt. Six weeks later she showed full recovery with no recurrence at follow-up.

🚨 9. When to Contact the Vet

• Noisy or labored breathing
• Ongoing ear signs or head tilt
• Voice change or trouble swallowing
• Suspected recurrence

✨ 10. Final Thoughts

Nasopharyngeal polyps are benign but behavior-impacting lesions that can compromise breathing, hearing, and comfort. With accurate diagnostics—especially imaging and endoscopy—and timely treatment (traction with medical management or surgical removal via VBO), most cats fully recover. Long-term follow-up and care at home are key. Ask A Vet offers tele-support, reminders, and monitoring tools to guide you through recovery with confidence 🐾❤️.

Need personalized aftercare plans, tele-vet check-ins, or post-surgical tracking support? Visit AskAVet.com or download the Ask A Vet app. We're here every step of the way.