Treatment of Chronic Sinusitis in Orangutans (pongo sp.) by Functional Endoscopic Sinus Surgery
American Association of Zoo Veterinarians Conference 2012

Hanspeter W. Steinmetz1, DrMedVet, MSc, DACZM, DECZM (Zoo Health Management); Nina Zimmermann2, DrMedVet; Robert Zingg3, Dr; Michael Heistermann4, Dr; Hans R. Briner, DrMedFMH; Klinischer Dozent5

1Gebr. Knie AG, Knies Kinderzoo, Switzerland; 2Tezet, Tiermedizinisches Zentrum AG, Switzerland; 3Zoo Zurich, Zurich, Switzerland; 4Reproductive Biology Unit, German Primate Center, Germany; 5Center for Otology, Skull Base Surgery, Rhinology, and Facial Plastic Surgery, Hirslanden Clinic, Switzerland


Chronic upper respiratory tract diseases (URTD) such as common cold, sinusitis, and airsacculitis, are common health problems in captive orangutans (Pongo abelii, P. pygmaeus).2-7 A previous study identified chronic sinusitis as a primary stage of airsacculitis in captive orangutans.7 Comparable to human medicine, orangutans with diagnosed sinusitis that is unresponsive to long-term intensive medical treatment might be potential patients for minimally invasive functional endoscopic sinus surgery (FESS) to improve their wellbeing and to prevent further disease progression. Orangutans considered for FESS must be examined thoroughly, including a computed tomography scan (CT), to evaluate the upper respiratory tract to display individual anatomic structures. Anesthesia should be regarded as a high-risk immobilization, and anesthetized orangutans should be intubated in a sitting position immediately after induction to prevent pulmonary aspiration of pathologic exudates. For CT scanning, orangutans should be positioned in ventral recumbency for best display of possible fluid levels.6

The purpose of the surgery is to re-establish ventilation and mucociliary clearance of the sinuses. Preoperative medical management includes ten days of antibiotics according to drug resistance testing and a three-day course of steroids. The minimally invasive FESS technique also requires extensive training and specialized endoscopic and surgical instruments to ensure best surgical results.1 Preliminary results of the study in the captive European orangutan population revealed a promising long-term outcome of FESS as a treatment of chronic sinusitis and airsacculitis, thus increasing the welfare of orangutans suffering from chronic upper respiratory tract disease.


The authors thank especially Mr. T. Hoffmann; Anklin Ltd., Medical Supplies, Binningen, Switzerland; and Mr. C. Hartwig, Karl Storz GmbH & Co., for providing all the endoscopic equipment and technical support during the procedures. The work and organization of all participating zoos is gratefully appreciated.

Literature Cited

1.  Briner HR, Simmen D, Jones N. Endoscopic sinus surgery: advantages of the bimanual technique. Am J Rhinol. 2005;19:269–273.

2.  Cambre RC, Wilson HL, Spraker TR, Favara BE. Fatal airsacculitis and pneumonia, with abortion, in an orangutan. JAVMA. 1980;177:822–824.

3.  Clifford DH, Yoo SY, Fazekas S, Hardin CJ. Surgical drainage of a submandibular air sac in an orangutan. JAVMA. 1977;171:862–865.

4.  Herrin KA, Spelman LH, Wack R. Surgical air sac resection as a treatment for chronic airsacculitis in great apes. In: Proceedings from the American Association of Zoo Veterinarians. 2002;369–371.

5.  McManamon R, Swenson RB, Orkin JL, Lowenstine LJ. Update on diagnostic and therapeutic approaches to airsacculitis in orangutans. In: Proceedings from the American Association of Zoo Veterinarians. 1994;193–194.

6.  Steinmetz HW, Zimmermann N. Use of computertomography to diagnose sinusitis and air sacculitis in orangutans (Pongo pygmaeus, Pongo abelii). In: Fowler ME, Miller E, eds. Zoo and Wild Animal Medicine: Current Therapy Vol. VII.  St. Louis, MO: Elsevier Saunders; 422–430.

7.  Zimmermann N, Pirovino M, Zingg R, Clauss M, Kau FJ, Heistermann M, Hatt JM, Steinmetz HW. Upper respiratory tract diseases in captive orangutans (Pongo abelii, Pongo pygmaeus): prevalence in 20 European zoos and possible predisposing factors. J Med Primatol2011;40:365–375.


Speaker Information
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Hanspeter W. Steinmetz, DrMedVet, MSc, DACZM, DECZM (Zoo Health Management)
Gebr. Knie AG
Knies Kinderzoo
Rapperswil, Switzerland

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