Ear

Question 1

What is otitis externa

Answer 1

inflammation of the vertical or horizontal ear canal or both

Question 2

define otitis media

Answer 2

inflammation of the tympanic cavity and membrane

Question 3

define otitis interna

Answer 3

inflammation of inner ear that typically causes vestibular disease in dogs, always caused by extension of infection into petrosal bone from otitis media

Question 4

define presbycusis

Answer 4

age related hearing loss

Question 5

what should the owner be aware of before ear surgery

Answer 5

be aware of dog’s hearing deficits before sx to reduce any O dissatisfaction associated with any perceived hearing loss post op

Question 6

are sx interventions used to tx ear disease painful?

Answer 6

yes

Question 7

what should be fully integrated into every phase of dx, tx, and recovery?

Answer 7

pain management

Question 8

what is the role of a pain scale

Answer 8

guide analgesic therapy, not deny it

Question 9

should you convince yourself the pt is in pain before tx?

Answer 9

no, treat early for pain

Question 10

what is the inner ear

Answer 10

membranous and bony labyrinth, functions for hearing and balance

Question 11

what is the middle ear

Answer 11

formed by tympanic cavity and connects pharynx via auditory tube

Question 12

what is external ear

Answer 12

formed by auditory meatus and short canal

Question 13

how is the feline tympanic cavity divided?

Answer 13

divided into two compartments by a thin bony septum that arises along cranial aspect of bulla and curves to attach to the midpoint of lateral wall

Question 14

how is complete drainage of the middle ear achieved in cats?

Answer 14

perforate bony septum

Question 15

which nerves are traumatized during surgical curettage of the feline middle ear and what does it cause

Answer 15

facial nerve, promontory -> horner’s syndrome

Question 16

what are the clinical signs of horner’s syndrome?

Answer 16

drooping eyelid, miosis, sunken appearance of affected eye, prominent third eyelid

Question 17

what are clinical signs associated with facial n paralysis?

Answer 17

diminished palpebral reflex, widened palpebral fissure, drooping of ear and lip, excessive drooling, blepharospasm, elevation and wrinkling of lip, caudal displacement of labial commissure

Question 18

why is it important to document the presence of horner syndrome and facial n paralysis before surgery?

Answer 18

keep from mistaking them for sx complication

Question 19

when is a lateral ear canal resection indicated?

Answer 19

minimal hyperplasia of the ear canal epithelium, small neoplastic lesions of the lateral aspect of the vertical canal

Question 20

describe lateral ear canal resection and owner satisfaction

Answer 20

O satisfaction is low when lateral ear canal resection is performed for chronic otitis externa in dogs

Question 21

what is a zep procedure?

Answer 21

modified lateral ear canal resection - forms a drain board which restricts hair growth at horizontal canal opening

Question 22

what should the owner understand about lateral ear canal resection?

Answer 22

not a cure and medical management of the ear will be necessary for life

Question 23

when is a vertical ear canal ablation performed?

Answer 23

when entire vertical canal is diseased BUT horizontal canal is NORMAL

Question 24

when is a vertical ear canal ablation be the tx of choice?

Answer 24

neoplasia is confined to vertical canal, in some animals with chronic otitis externa

Question 25

if there is an abundance of hyperplastic tissue around the vertical canal, which procedure has better cosmetic appearance?

Answer 25

vertical ear canal ablation

Question 26

why is a TECA always performed in conjunction with a LBO for otitis externa and media?

Answer 26

removes avenue for drainage of exudative material and treats otitis media

Question 27

because of the potential for serious complications, when should the TECA LBO not be performed?

Answer 27

on animals with mild dz or by surgeons unfamiliar with anatomy of the ear

Question 28

what is the technique of choice when middle ear neoplasia is suspected in cats with nasopharyngeal polyps?

Answer 28

ventral bulla osteotomy

Question 29

what does the ventral bulla osteotomy allow?

Answer 29

allows both bullae to be opened without need to reposition animal

Question 30

bandages or excessive swelling after bilateral TECA LBO may impair what

Answer 30

respiration

Question 31

what is common in cats after ventral bulla osteotomy?

Answer 31

horners syndrome and facial n paralysis - typically transitory

Question 32

what is a complication of teca lbo that may be life threatening?

Answer 32

intraoperative arterial hemorrhage

Question 33

when does facial n paralysis resolve?

Answer 33

within a few weeks of sx

Question 34

what percent of cats have facial n paralysis after teca?

Answer 34

56% of cats

Question 35

how many cats experience permanent facial n paralysis after teca?

Answer 35

1/4

Question 36

what causes aural hematomas in cats?

Answer 36

otodectes cynotis

Question 37

what is important when diagnosing aural hematomas?

Answer 37

underlying dz must be ID and treated to decrease recurrence

Question 38

what are complications of a teca-lbo?

Answer 38

superficial wound infection, facial n paralysis, vestibular dysfunction, deafness, avascular necrosis on pinna

Question 39

what is the most common tx of aural hematomas?

Answer 39

incise tissue overlying hematoma, evacuate blood clots and fibrin, hold cartilage in apposition until scar tissue can form

Question 40

what are alternative methods to tx aural hematomas?

Answer 40

placement of a drain or cannula to provide drainage for several weeks during healing

Question 41

what method of tx of aural hematoma does not require sutures?

Answer 41

laser

Question 42

what type of incision is made on concave surface of ear for aural hematomas and how far does it extend?

Answer 42

s shaped, from end to end

Question 43

how are the sutures placed for aural hematomas?

Answer 43

parallel to major vessels (vertical)

Question 44

what should NOT be done during the aural hematoma sx?

Answer 44

do not ligate visible branches of the great auricular artery, do not suture incision closed

Question 45

what is an alternative way that the ear can be secured during aural hematoma repair?

Answer 45

secured using a hematoma pad

Question 46

what are the most common neoplasias on the pinna and external ear canal from?

Answer 46

from ceruminous glands

Question 47

which species has more aggressive neoplasia of the pinna or external ear canal?

Answer 47

more aggressive in cats

Question 48

what is neoplasia of the pinna and external ear canal often associated with?

Answer 48

otitis externa, media, interna

Question 49

what is the most important aspect of surgery for ear neoplasms?

Answer 49

achieve wide margins to prevent local recurrence

Question 50

if aggressive sx therapy cannot provide clean margins for ear neoplasms, what should be considered?

Answer 50

adjunctive therapy (radiation)

Question 51

how should malignant ear tumors be excised?

Answer 51

wide margins of normal tissue, owner should be advised of the cosmetic defect before surgery

Question 52

what is the surgical technique for small tumors on the central portion of the convex surface of the pinna?

Answer 52

resect neoplasm, mobilize skin around defect by undermining between cartilage and skin, suture skin margins or heal by second intention

Question 53

for malignant ceruminous gland tumors, is ablation curative

Answer 53

seldom, consider adjunctive therapy

Question 54

when is local recurrence of SCC common?

Answer 54

if wide margins not obtained

Question 55

what is the prognosis of SCC of the middle ear and inner ear

Answer 55

poor

Question 56

describe mast cell tumor of pinnae

Answer 56

aggressive in terms of metastasis

Question 57

describe early surgical tx of aural cholesteatoma in the bullae

Answer 57

curative, recurrence with advanced dz

Question 58

what is the most common tumor of the pinna in cats

Answer 58

scc

Question 59

signalment of cats with scc

Answer 59

older cats, white cats or cats with lack of protective pigment of ear pinna

Question 60

what is a causative factor of scc

Answer 60

solar radiation

Question 61

is scc metastasis common

Answer 61

no, usually to regional lymph nodes

Question 62

where else may scc of the pinna be noted

Answer 62

nares and eyelids

Question 63

what is the second most common cause of nasopharyngeal disease in cats

Answer 63

inflammatory polyps

Question 64

what is the cause of inflammatory polyps

Answer 64

unknown

Question 65

signalment of inflammatory polyps in cats

Answer 65

young cats <2 years

Question 66

hx of cats with inflammatory polyps

Answer 66

present of evaluation of dysphagia or URI signs, signs of otisis externa, acute onset of head tilt, nystagmus, vestibular imbalance

Question 67

PE findings of inflammatory polyps

Answer 67

most are unilateral, upper respiratory obstructive signs

Question 68

diagnostic imaging for nasopharyngeal polyps

Answer 68

lateral radiographic images of pharyngeal region, CT is gold standard to determine extent of involvement

Question 69

when are best results seen for surgical tx of nasopharyngeal polyps

Answer 69

ventral bulla osteotomy performed , recurrence rate <2%

Question 70

when should a ventral bulla osteotomy ALWAYS be performed

Answer 70

if middle ear disease is evident on rads or CT

Question 71

prognosis of nasopharyngeal polyps

Answer 71

excellent with complete removal of polyp, unlikely to affect hearing