Revision Surgical Management of Refractory Nasal Vestibular Stenosis in an Exotic Shorthair Cat Using a Combined Surgical Technique and a Steroid-Eluting Implant (PROPEL Contour)

Severe nasal vestibular stenosis in brachycephalic cats involves species-specific anatomical structures distinct from those in dogs, often leading to a high recurrence rate even after standard surgical correction. This case report introduces an innovative surgical strategy for a refractory Exotic Shorthair cat presenting with obligate open-mouth breathing and complete nasal obstruction despite three previous surgical interventions. To remove the recurrent scar tissue and maximize the nasal vestibular lumen, a combined surgical approach was performed, incorporating a ventral vertical resection, bilateral wedge resections, and bilateral single pedicle advancement flaps. To maintain the acquired airway and prevent restenosis, a steroid-eluting bioabsorbable implant (PROPEL Contour) was placed within the resected nasal vestibule, marking its first application in veterinary medicine. Postoperatively, open-mouth breathing resolved immediately. At the long-term 20-month follow-up, normal nasal breathing was maintained without restenosis or nasal discharge, with complete resolution of all preoperative clinical signs, and no implant-related adverse effects or infections were observed. The concurrent application of radical structural resection and a PROPEL Contour implant effectively suppresses tissue regrowth and maintains stable nasal patency, offering a highly promising therapeutic protocol for refractory feline nasal vestibular stenosis.