13 Tecalbo ears Flashcards
What are the surgical treatments for refractory otitis externa?
- Lateral ear canal ablation,
- vertical ear canal ablation,
- total ear canal ablation,
- ventral bulla osteotomy (cat)
What is lateral ear canal ablation used for?
- Increases drainage and improves ventilation of the ear canal.
- Facilitates placement of topical agents into the horizontal canal.
- Indicated in patients with minimal hyperplasia of the ear canal epithelium or with small neoplastic lesions of the lateral aspect of the vertical canal.
What does vertical ear canal ablation target?
When the entire vertical canal is diseased but the horizontal canal is normal.
What conditions necessitate total ear canal ablation?
- Both horizontal and vertical canals affected,
- middle ear disease
What is the purpose of ventral bulla osteotomy?
- Nasopharyngeal polyps,
- middle ear infection
What is the most common surgical approach for feline middle ear?
Ventral bulla osteotomy
What is a potential complication of ventral bulla osteotomy?
- Damage to the facial nerve - drooping lip, difficulty eating
- Horner’s syndrome- third eyelid prolapsed, constricted pupil, and upper eyelid droop
- vestibular symptoms - head tilt, nystagmus,
What is the anatomical difference between dog and cat middle ears?
Feline middle ears (bullae) have 2 chambers
What are the three radiographic views to image the middle ear?
- Dorsoventral
- Lateral (+/- oblique skull L and R),
- Open mouth Rostroventral caudodorsal 30 degree oblique
What advantage does CT have over radiography for middle ear imaging? (3)
Much more sensitive at picking up small amounts of fluid, subtle periosteal changes, thickening or lysis of bulla wall
What are three indications for TECALBO in a dog?
- Persistent otitis externa refractory to medical management,
- patient factors (too aggressive to medicate),
- neoplasia (ceruminous gland adenocarcinoma)
What are the indications for lateral ear canal resection?
- Congenital canal stenosis
- small tumours of the tragus,
- refractory otitis externa of horizontal +/- vertical ear canal
What is a common indication for ventral bulla osteotomy?
- Chronic Otitis media
- NP polyps (cats)
- middle ear tumours
What are seven complications associated with TECALBO?
- Hearing loss
- Horner’s syndrome
- Facial nerve damage
- Massive haemorrhage
- Ischemia of the pinna
- Vestibular dysfunction
- Chronic fistulation
What is a sign of facial nerve damage?
- Droopy eyelid,
- no blink on that side- dry eye
- dropped ear on that side
What should be done during careful dissection of ear canal resections to avoid massive hemorrhage?
Be cautious of large veins such as the retroarticular vein
What samples should be collected during TECALBO?
- Sample of middle ear discharge for culture and sensitivity,
- Bone culture
- Deep bulla culture if grossly abnormal
Fill in the blank: _______ is a potential complication due to damage of deep pinnal arteries/veins.
Ischemia of the pinna
What nerve supplies lacrimal glands
Opthalmic branch of the trigeminal nerve
what nerve is involved if you see miosis, eyelid drooping and third eyelid prolapse?
sympathetic trunk/nerve supply
What is Horner’s syndrome?
A neurological condition resulting from disruption of sympathetic nerves supplying the eye and surrounding structures.
True or False: Horner’s syndrome can result from a tumor in the apex of the lung.
True
What are the classic symptoms of Horner’s syndrome?
Ptosis, miosis, and anhidrosis.
Fill in the blank: Horner’s syndrome is characterized by a drooping eyelid known as __________.
ptosis
What is the term for constriction of the pupil seen in Horner’s syndrome?
Miosis
Which layer of the nervous system is affected in Horner’s syndrome?
The sympathetic nervous system.
True or False: Horner’s syndrome affects both eyes equally.
False
Multiple choice: Which of the following is NOT a symptom of Horner’s syndrome? A) Anhidrosis B) Mydriasis C) Ptosis
B) Mydriasis
What type of imaging is commonly used to investigate suspected causes of Horner’s syndrome?
MRI or CT scan.
What is the primary treatment for Horner’s syndrome?
Treating the underlying cause.
True or False: Horner’s syndrome can be congenital.
True
Short answer: Name one congenital cause of Horner’s syndrome.
Congenital Horner’s syndrome can be caused by birth trauma.
Multiple choice: Which condition is associated with Horner’s syndrome? A) Stroke B) Glaucoma C) Diabetes
A) Stroke
What is the role of the sympathetic nervous system in the eye?
It dilates the pupil and raises the eyelid.
True or False: Horner’s syndrome can occur as a result of cervical or high thoracic (T1-T2) spine injury.
True
What is the prognosis for Horner’s syndrome if the underlying cause is treated?
It can improve or resolve depending on the cause.
