Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

SX, OPHTH, DENT > Ear Surgery > Flashcards

Ear Surgery Flashcards

(83 cards)

Start Studying
1
Q

What are different diseases that can affect the pinna

A

1) Physical injuries
-Aural hematoma
-Wounds of pinna
-Lacerations

2) Neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the different structures of the ear

A

1) Pinna
2) Vertical ear canal
3) Horizontal canal
4) Middle/Inner ear
5) Osseous bullae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What structures make up the external ear canal

A

1) Horizontal
2) Vertical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aural hematomas occur within the

A

Cartilage clefts of the pinna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are risk factors for aural hematoma

A

1) Head shaking
2) Pinna trauma / ear scratching - foreign body, allergies, etc.
3) External ear infection
4) Immune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you diagnose aural hematoma

A

Do ear examination. Try to find cause

1) Infection
2) Foreign body
3) Neoplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you treat aural hematomas

A

1) Conservative
-Aspiration +/- steroid injection

2) Surgical
-Incision, drainage, suture
-Teat tube or indwelling drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are advantages of treating aural hematoma with aspiration and steroid injection

A

No general anesthesia
Outpatient
No ear disfigurement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the disadvantages of treating aural hematoma with aspiration and steroid injection

A

1) Clots left
2) Recurrence 10-25%
3) Bandage required (head bandages hard to keep in place)
4) Requires multiple injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Aural hematomas often require multiple steroid injections. What can you use

A

1) Dexamethasone (0.2-0.4mg in saline every 24 for 1-5 days

2) Methylprednisolone 0.5 to 1.0ml every 7 days for 1-3 weeks

3) Triamcinolone 0.1 to 1.0ml every 7 days for 1-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If treating aural hematomas with aspiration and steroid injection, what is the recurrence

A

10-25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is surgical treatment of aural hematoma performed

A

1) S-shaped incision on concave surface
2) Massage and Lavage to remove clots
3) Multiple staggered rows of full thickness- mattresses
4) Monofilament non-absorbable suture
5) Knots on the concave side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F: aural hematoma surgery requires general anesthesia

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Incisions for aural hematomas are made on what surface of the pinna

A

the concave surface

do a linear incision: parallel to the blood supply (S-shaped incision)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When surgically fixing an aural hematoma, how should you position your sutures

A

1) Multiple staggered rows of full thickness- mattresses
2) Monofilament non-absorbable suture
3) Knots on the concave side

Positioned parallel with the incision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are other surgical techniques for aural hematomas

A

Punch biopsy 4 or 6 mm
1-1.5cm apart on conclave part - staggered
skin edge through each hole is tacked to the cartilage 3-0 or 4-0 absorbable suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the main advantages for aural hematoma sx

A

1) Easy clot removal
2) Low recurrence
3) Bandage for 48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the disadvantages of aural hematoma sx

A

Anesthesia
Scar +/- deformity of ear (erect ear carriage may become floppy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What do you do for lacerations of the pinna that only are one skin surface thick

A

Debridement
Closure - skin over top of cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What do you do for lacerations of the pinna that are one or two skin surfaces + cartilage thick

A

Debride
Closure both skin layers

Risk: aural hematoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Trauma and avulsion of the pinna is typically rupture of what

A

rupture of cartilage between auricular and annular cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What can pinna avulsion lead to

A

obstruction of the proximal vertical ear canal by pseudotympanic membrane and external auditory canal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How do you treat pinna trauma and avulsion

A

Debride and repair
Suture open the annular cartilage to the skin
-TECA-LBO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What neoplasia typically occurs at the pinna

A

1) Squamous cell carcinoma
2) Hemangioma/ hemangiosarcoma
3) Basal cell carcinoma
4) Mast cell tumor
5) Chondroma or chondrosarcoma
6) Fibrosarcoma
7) Histiocytoma
8) Sebaceous Adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What do you do for neoplasia of the pinna
-Surgical excision -Cryosurgery (2-3 freeze thaw cycles) -Ear amputation
26
If you see squamous cell carcinoma on ear of cat, what should you recommend doing
might need to also amputate the other ear taking down to base
27
What diseases typically affect the external ear canal (vertical and horizontal ear canal) in dogs
1) Infection 2) Neoplasia -Ceruminous gland adenocarcinoma -Sebaceous gland adenoma or adenocarcinoma -Chondroma or chondrosarcoma -Soft tissue sarcoma -Melanoma
28
T/F: External ear canal neoplasia is often benign in dogs
false 60% of them are malignant
29
T/F: External ear canal neoplasia has no different distribution between horizontal and vertical canal in dogs
True
30
External ear canal neoplasia is often unilateral or bilateral in dogs
Unilateral > bilateral
31
What breeds are often overrepresented for External ear canal neoplasia in dogs
Cockerspaniels
32
T/F: external ear canal neoplasia is often malignant in cats
True- 88% are malignant -Ceruminous gland adenocarcinoma -Squamous cell carcinoma -Anaplastic carcinoma -Sebaceous gland adenocarcinoma
33
External ear canal neoplasia is often unilateral or bilateral in cats
Bilateral is common (unlike dogs where unilateral is more common)
34
What do you do for neoplasia of the external ear canal
-Biopsy -Cryosurgery -Lateral ear resection -Total Ear Canal Ablation and Lateral Bulla Osteotomy (TECA-LBO)
35
What are the indications for surgery for external ear canal infection
1) Medical therapy failed 2) Aural integument irreversibly diseased 3) Development of cutaneous fistulas 4) Para-aural abscess 5) Otitis media or otitis interna (often failed- bc medical management still recommended)
36
What are the surgical approaches to external ear infections
1) Lateral wall resection +/- ventral bulla osteotomy 2) Resection of vertical ear canal +/- ventral bulla osteotomy 3) Total ear canal ablation -Lateral bulla osteotomy
37
Whenever total ear canal ablation is done, it is also required to do
Lateral bulla osteotomy
38
What might you do in addition to 1) lateral wall resection or 2) resection of the vertical ear canal
Ventral bulla osteotomy
39
What are the indications for latera lwall resection
1) Otitis externa is reversible * 2) Small tumor of tragus or lateral wall of vertical canal NOT extending into the horizontal canal 3) Patent horizontal ear canal
40
Cockerspaniels are not good candidates for what external ear infection surgery
Lateral wall resection high rate of failure in cocker spaniels die to underlying skin and ear condition
41
What are the goals of lateral wall resection
1) Opens up the horizontal canal 2) Improves canal ventilation 3) Reduces moisture, humidity, and temperature 4) Easier to medicate
42
If otitis externa is reversible, what external ear infection sx can you do
Lateral wall resection
43
How is lateral wall resection done
incision line made ventral to the tragus just superficial to the vertical canal cartilage is then dissected so the horizontal ear canal is open 1) Opens up the horizontal canal 2) Improves canal ventilation 3) Reduces moisture, humidity, and temperature 4) Easier to medicate
44
Lateral wall resection has good results if
1) Done early 2) Owners must continue to treat underlying cause of otitis (allows them to treat better) 3) Not a cockerspaniel
45
Why is ventral bulla osteotomy also done with lateral wall resection
if they have middle ear disease, opens up the middle ear more
46
What are complications of lateral wall resection
1) Failure rates: 34-55% (poor patient selection like Cocker spaniels) 2) Dehiscence of incision -Tension -Chronic infection -Slow healing 3) Stenosis of horizontal ear canal 4) Self trauma - manage with ecollar
47
What are the indications for vertical ear canal resection
1) Vertical ear canal severely diseased 2) Horizontal ear canal NORMAL 3) Trauma- ie avulsions 4) Neoplasia or otitis externa of the vertical canal only rarely performed - unusual for otitis externa or neoplasia to be isolated to the vertical canal
48
Vertical Ear canal resection is rarely performed. How do
Because it is unusual for otitis externa or neoplasia to be isolated to the vertical canal
49
What does the vertical ear canal resection achieve
removes the vertical ear canal
50
__________ opens up the vertical ear canal, while ____________ removes it
Lateral wall resection ; vertical ear canal resection
51
How is a vertical ear canal resection performed
1) T incision made, avoid facial nerve and parotid gland 2) Vertical ear canal is removed 3) Suture horizontal ear canal to the skin
52
What are the indications for Total ear canal ablation + bulla osteotomy
1) Chronic disease 2) End stage external ear disease - narrowing 3) Narrow horizontal ear canal 4) Neoplasia of ear canal 5) Extensive middle ear disease
53
What does TECA-LBO stand for
Total ear canal ablation + bulla osteotomy
54
What should you do pre-op of Total ear canal ablation + bulla osteotomy
1) Exam- document pre-op nerve deficit 2) Advanced imaging CT- a) especially if nerve deficits or pain on opening of the mouth b) Concern for middle ear disease/extension
55
50% of chronic otitis externa cases have
otitis media
56
Why is it important to do CT prior to Total ear canal ablation + bulla osteotomy
concern for middle ear disease / extension especially if nerve deficits or pain on opening of the mouth
57
How is Total ear canal ablation + bulla osteotomy performed
1) Inflammed proliferative tissue is removed and go around vertical and horizontal canal taking tissue out 2) Once you get down to external acoustic meatus where opening to bullae is 3) Do a Lateral Bulla osteotomy 4) Debride the entire epithelium and open the bullae up 5) Culture
58
What ear structure is kept with Total ear canal ablation + bulla osteotomy
pinna
59
When doing Total ear canal ablation + bulla osteotomy what structure is really close to the external acoustic meatus that is a complication
Facial nerve
60
What are complications of Total ear canal ablation + bulla osteotomy
1) Facial nerve palsy 2) Horner's syndrome - ptiosis, miosis, enophthalmos, protusion of nictitating membrane 3) Inner ear infection - head tilt, mystagmus, ataxis 4) Hemorrhage 5) Fistula tracts 6) Loss of hearing
61
What are the clinical signs of Horner's syndrome
1) Ptosis 2) Miosis 3) Enophthalmos 4) Protrusion of nictitating membrane
62
What are the clinical signs of an inner ear infection
1) Head tilt 2) Nystagmus 3) Ataxia
63
Horner's syndrome after Total ear canal ablation + bulla osteotomy is more common in what species
Cats > Dogs
64
What is true of facial nerve paralysis after
36% of cases Improves within 2-4 weeks 4-13% permanent
65
What is the prognosis of Total ear canal ablation + bulla osteotomy
overall success rate of 90-95% difficult procedure
66
What diseases affter the middle/inner ear
Infection Polyps (commonly cats) Neoplasia Foreign Bodies Trauma
67
What is the most common disease of the middle ear in dogs
1) Otitis media -Staphylococcus -Streptococcus -Pseudomonas -E Coli -Proteus mirabilis 2) Foreign bodies
68
How does bacteria reach the middle ear to cause otitis media
1) Tympanic membrane (from otitis externa) 2) Eustachian tubes by the nasopharynx 3) Hematogenous
69
T/F: bacterial middle ear infections in cats secondary to otitis externa is common
False - it is quite rare
70
How do you diagnose otitis media
Physical exam Oropharyngeal exam Otoscopic exam Radiographs/CT scan of bulla (air density or bone density)
71
What does the bullae look like normally on radiographs
air filled and radiolucent
72
What are the surgical indications for septic otitis media / interna
1) Lack of improvement with medical management after 4-6 weeks 2) Neurologic signs requiring tympanic decompression
73
Why is jsut doing a ventral bulla osteotomy rare in dogs
because you typically have severe external ear canal disease do dogs most commonly get TECA-LBO ( Total ear canal ablation + bulla osteotomy)
74
Ventral bulla osteotomy can be done if
the patient only has otitis media Not very common: because you typically have severe external ear canal disease do dogs most commonly get TECA-LBO ( Total ear canal ablation + bulla osteotomy)
75
Why might cats get a ventral bullae osteotomy
polyps from the middle ear that extend into the nasopharynx and through the estuchian tube
76
How many compartments does the cat bullae have
2
77
Polyps are secondary to
chronic inflammation
78
polyps are seen in what kind of cats
young cats
79
What diseases of the middle ear do cats commonly get
1) Neoplasia - do CT scan or biopsy 2) Inflammatory polyps of middle ear (more common) occur in bulla, external ear canal, or nasopharynx
80
What can be a result of polyps in a cat's nasopharynx
respiratory difficulties
81
What is the prognosis of polyps
good prognosis
82
How do you fix polyps in cats
If in nasopharynx: lift soft palate and pull out if localized and havent left the middle ear then you can do a bulla osteotomy
83
What are the complications of Ventral bulla osteotomy
Horner's syndrome Vestibular Signs

SX, OPHTH, DENT (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions