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Surgical Conditions of The Ear Flashcards

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1
Q

what are the main conditions affecting the pinnae?

A

trauma - lacerations
aural haematoma
neoplasia

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2
Q

what causes aural haematoma?

A

head shaking causing bleeding between the skin of the ear and the cartilage

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3
Q

when does aural haematoma arise?

A

usually secondary to other conditions which are causing the dog to shake it’s head

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4
Q

what are the 2 main types of neoplasia seen on the pinna?

A

squamous cell carcinoma

melanoma

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5
Q

what animals are more prone to neoplasia of the pinna?

A

white haired
hairless
unpigmented skin

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6
Q

what can be used to protect at risk skin on the pinna from neoplasia?

A

high factor childs sun cream

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7
Q

what makes up the external ear canal?

A

vertical and horizontal canals

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8
Q

what is otitis externa?

A

dermatological disease affecting the ear

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9
Q

what is the most common infection in dogs?

A

otitis externa

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10
Q

what are the main causes of otitis externa?

A

immune mediated (allergic)
parasitic infection
poor aeration due to conformation
seconday to middle ear infection (cats)

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11
Q

what is the name of the ear mite of dogs, cats, rabbits and ferrets?

A

otodectes cynotis

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12
Q

how can poor aeration of the ears be caused and lead to otitis externa?

A

floppy ears
mechanical obstruction (hair/FB)
neoplasia
chronic inflammatory changes due to previous otitis externa leading to calcification and thickening

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13
Q

when is otitis externa seen in cats?

A

secondary to middle ear problems

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14
Q

what is the most common condition of the ears in cats?

A

middle ear issues

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15
Q

what are the main types of neoplasia which affect the ear canals?

A

squamous cell carcinoma
melanoma
basal cell carcinoma
ceruminous gland adenoma (benign) or adenocarcinoma (malignant)

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16
Q

what is the survival rate for squamous cell carcinoma of the ear canal?

A

at least one year after surgery

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17
Q

why is squamous cell carcinoma invasive?

A

may metastasize

if multi centeric further lesions can appear after removal

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18
Q

where is the ceruminous gland found?

A

sub-dermal layers of the ear canal

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19
Q

what is the role of the ceruminous gland?

A

helps produce wax

protects ear

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20
Q

what is the issue with melanoma?

A

more deadly as spreads quickly

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21
Q

what is the most common skin tumor in dogs and cats?

A

basal cell carcinoma

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22
Q

how severe is basal cell carcinoma?

A

normally benign but can grow quickly

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23
Q

what are the main middle ear diseases of dogs?

A

bacterial otitis media
tympanic membrane trauma allowing bacterial infection
tumors are rare unless an extension of another tumor

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24
Q

what is otitis media?

A

inflammation in the middle ear

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25
what is bacterial otitis media most often caused by in dogs?
development of chronic otitis externa
26
what are the most common middle ear diseases in cats?
otitis media without otitis externa neoplasia (rare) polyps
27
what is otitis externa in cats normally due to?
primary middle ear disease
28
what is the most common mass diagnosed in cats?
polyps
29
what are the areas in cats affected by polyps?
pharyngeal | external ear canal
30
what causes polyps in cats?
unknown aetiology
31
what are the 3 common presentations of polyps?
only in bulla (middle ear) protruding through tympanic membrane nasopharyngeal
32
what is caused by polyps protruding through tympanic membrane?
concurrent otitis externa
33
where do nasopharyngeal polyps grow from?
eustachian tube
34
what is involved in the surgical treatment of all issues with the pinnae?
treatment of underlying case
35
what lacerations will be treated surgically?
full thickness lacerations or epithelium torn away from cartilage
36
what must be considered about ear lacerations?
need for flushing as there is infection risk
37
why does cartilage take longer to heal?
poor blood supply
38
what is the purpose of surgical correction of auricular haematoma?
prevent further accumulation and deformity | allow fibrosis of the skin and cartialge
39
how can an aural haematoma be prevented from reforming after drainage?
use correctly placed sutures to hold skin and cartilage together
40
what is involved in correction of auricular haematoma?
suction and drainage | massage and flush
41
can auricular haematoma resolve without treatment?
yes in some cases
42
what surgical prep is needed for auricular haematoma?
full clip of pinna
43
what positioning is required for auricular haematoma surgery?
lateral recumbancy
44
what post of care is needed for the auricular haematoma patient?
bandaging to immobilise pinna | buster collar
45
what is the issue with ear bandages?
affect ventilation of ear canal and so can lead to otitis externa
46
when performing pinna neoplasia surgery what must be considered?
site size histology needed and so pot size
47
what is pinnectomy?
full removal of pinnae
48
what is pinnectomy used for?
removal of invasive tumors
49
what is a significant side effect of pinnectomy?
bleed profusely so bipolar cautery needed for haemostasis
50
what is removed during a lateral wall resection?
secretory epithelium of vertical canal | lateral cartilage of vertical canal
51
in what animals is lateral wall resection used?
chronic OE patients not responding to treatment external canal disease
52
when must lateral wall resection be performed?
early before any stenosis (thickening)
53
what is the purpose of a lateral wall resection?
increases drainage and ventilation
54
what is required post lateral wall resection?
medical management as non-curative
55
what clip is needed for lateral wall resection?
entire pinna and side of head
56
what should be done prior to lateral wall resection prep?
flush ear to remove debris
57
what position should animals be in for lateral wall resection?
lateral recumbency | head elevated
58
what is involved in a vertical canal ablation?
excision of whole auricular cartilage and formation of a stoma at the level of the horizontal canal
59
what is vertical canal ablation used to treat?
disease affecting the entire vertical canal but not the horizontal e.g. neoplasia
60
what may be needed in vertical canal ablation?
histology samples
61
how is the patient prepped for vertical canal ablation/
as for lateral wall resection
62
what is the most common procedure performed on the ear in dogs?
total ear canal ablation (TECA)
63
when is a TECA performed on cats?
alongside lateral bulla osteotomy (LBO)
64
what is TECA and TECA-LBO used to treat?
chronic otitis externa that is unresponsive to medical treatment trauma neoplasia
65
what happens during TECA-LBO?
removal of all epithelial lining and vertical and horizontal canal cartilages
66
what are the potential serious complications associated with TECA-LBO?
neurological - facial nerve paralysis and hearing loss infection cosmetic
67
what is essential when conversing with owners about facial surgery?
prepare them for what their animal may look like meeting with owners who have had experience never let owners take a cat home without taking them out and showing them the surgical area
68
how should patients be prepped for TECA-LBO?
clip entire pinna, caudal boarder of eyelid and lateral side of neck prep entire pinna
69
what will need to be done throughout TECA-LBO prep?
pinna supported with towel clamp so it is held out of the way
70
how can hair be prevented from falling in the ear canal during clipping for surgery?
plug ear
71
what are the complications associated with TECA?
``` haemorrhage iatrogenic facial nerve injury vestibular problems trauma to deeper structures facial nerve paralysis Horner's syndrome infection fistula formation cholesteatoma ```
72
why is haemorrhage likely in TECA surgery?
limited visualisation
73
how can haemorrhage be prevented in TECA?
cautery swabbing suction (scrub nurse role)
74
what deeper structures may be injured following TECA?
lingual / maxillary vessels | hypoglossal nerve
75
what TECA complications are often self limiting?
facial nerve paralysis | Horner's syndrome
76
what is the most common TECA complication?
infection
77
what can infection lead to?
wound dehiscence
78
what is cholesteatoma?
keratinising epithelium that has been left behind by the surgeon that must be removed
79
in what animals is a ventral bulla osteotomy performed?
cats with middle ear disease
80
why is ventral bulla ostotomy not often performed in dogs?
rare for dogs to have isolated middle ear diease
81
what is ventral bulla osteotomy useful to treat?
middle ear polyps
82
what are the complications of ventral bulla osteotomy?
Horner's syndrome vestibular disease haemorrhage infection
83
why is communication with the owner of a surgical ear patient vital?
complications are common and frustrating to manage | informed owner will be more understanding if complications do occur
84
what is the role of the VN in surgical ear conditions?
prep of patient intra-operative support counseling of owners with VS post op care and observations

JJ (33 decks)

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