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CVSOH BVSc4 > Derm - Ear disease > Flashcards

Derm - Ear disease Flashcards

1
Q

What are the 4 types of factor to consider in cases of otitis externa?

A

Primary
Secondary - aggravate it
Predisposing - more likely to develop
Perpetuating - more likely to continue

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2
Q

What is the most common primary cause of otitis externa?

A

Allergic skin disease eg. atopic dermatitis, cutaneous adverse food reaction or contact dermatitis

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3
Q

What primary factors can cause otitis externa?

A

Allergic skin disease
Ectoparasites
Foreign bodies
Tumours
Autoimmune
Hypothyroidism

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4
Q

What secondary factors can exacerbate otitis externa?

A

Upsetting the ear microclimate
eg. inappropriate topical medication
Microbial overgrowth
Opportunistic infection - pseudomonas

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5
Q

What predisposing factors can increase the risk of getting otitis externa?

A

Conformation of the ear - floppy ears, narrow ear canals
Water/humidity in the ear - swimming
Inappropriate overcleaning
Trauma
Neoplasia - blocking ear canal

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6
Q

What are some perpetuating factors that can prolong otitis externa?

A

Lots of sebaceous glands producing cerumen - upregulation causing excess production encouraging microbial overgrowth
Excess cleaning can encourage upregulation
Stenosis of the ear canal due to chronic infection

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7
Q

What does chronic proliferative otitis externa cause?

A

Scarring, stenosis, deformity of the ear canal
Irreversible calcification of the cartilage
This is a perpetuating factor

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8
Q

What are the clinical signs of otitis externa?

A

Head shaking, scratching, pain
Ear canal firm on palpation
Discharge - cerumen, purulent or dark and tarry
Neuro signs - facial nerve paralysis, Horners syndrome

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9
Q

What nerves are located in the inner ear?

A

Facial nerve and vestibulocochlear nerve

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10
Q

What diagnostic tests can you do for ear disease?

A

Cytology of ear discharge
Tape impressions of skin folds
Culture

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11
Q

When should you culture ear discharge in ear disease?

A

When not responding to antibiotic treatment
When risk of antimicrobial resistance
When you find rods on cytology

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12
Q

What diseases do rods suggest if found on cytology from ear discharge?

A

Pseudomonas
E. coli
Klebsiella

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13
Q

What diagnostic tests should you do if you suspect middle ear disease (otitis media)?

A

Radiography
CT scan of tympanic bullae

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14
Q

What are signs of otitis media on CT scan?

A

Stenosis of external canal
Sclerosis, thickening of temporal bone
Sclerosis, thickening of tympanic bullae
Soft tissue opacity in bullae

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15
Q

How are cats middle ears different to dogs?

A

The have a bony septum in middle ear

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16
Q

How should you treat allergic skin diseases causing otitis?

A

Once/twice weekly ear cleaner and topical anti-inflammatories
Systemic glucocorticoids if this doesnt work

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17
Q

Why is pseudomonas difficult to treat?

A

Biofilm formation hides it from treatment, increases resistance

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18
Q

How do you treat pseudomonas?

A

PCMX
Marbofoxacin - fluoroquinolones
Gentamicin
Surgery?

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19
Q

What parasite can cause otitis?

A

Ear mites - otodectes cynotis
Some cats are very hypersensitive to them, others show no signs

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20
Q

How do you treat otodectes?

A

Selamectin and moxidectin
Canaural, surolan
Isoxazolines

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21
Q

What get polyps in their ears?

A

Cats from 5 months ot 5 years

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22
Q

What are polyps in the ears?

A

Benign inflammatory lesions located in the nasopharynx

23
Q

What are the clinical signs of polyps in the ears?

A

Persistent aural discharge
Otitis
Head shaking
Scratching
Head tilt
Nystagmus

24
Q

Which if these is not a primary cause of otitis externa?
A. grass seed
B. atopic dermatitis
C. keratinisation disorders
D. pseudomonas
E. otodectes cynotis

A

D. pseudomonas
Because it doesnt start the inflammatory process - only becomes a problem after inflammation already present

25
Q

Is otitis media a predisposing factor for otitis?

A

No - it is a perpetuating factor as it is only there because it has already had an ear infection before, makes it more likely to continue

26
Q

Is food allergy a predisposing factor for otitis?

A

No - it is a primary cause

27
Q

What is an aural haemotoma?

A

A blood filled swelling on the inner surface of the pinna

28
Q

What causes an aural haematoma?

A

Traumatic cartilage fracture and blood vessel rupture, separating the auricular cartilage from the skin

29
Q

What are the treatment options for aural haematoma?

A

Do nothing - not good
Corticosteroids - ineffective
Aspiration, flushing - recurrence likely
Small incision and place haematoma tube - drips, not tolerated well
Surgical repair

30
Q

What must you do in cases of aural haematomas?

A

Identify and treat the underlying condition eg. otitis

31
Q

What is the prognosis of surgical repair of an aural haematoma?

A

Excellent provided the underlying cause is addressed

32
Q

What is the simplest method of surgical repair of a aural haematoma?

A

S shaped incision
Then flush, remove clots
Add multiple staggered longitudinal sutures over whole haematoma incorporating the cartilage
Incision left open
Cover in dressing and bandage

33
Q

What should you do if there is material deep in the external ear canal?

A

GA and ear flush

34
Q

What are the complications of GA and ear flush?

A

Tympanic membrane damage
Neuro damage
Pain from irritation to the ear canal
Aspiration of fluid

35
Q

What type of procedure does GA and ear flush count as?

A

Dirty

36
Q

What types of suture should you use to repair the pinna from traumatic wounds?

A

Vertical mattress suture and figure of 8 suture

37
Q

When do you need to do a pinna resection?

A

Resection of neoplastic masses

38
Q

What ear procedure is illegal in the UK?

A

Ear cropping

39
Q

What is the name of the procedure when the lateral part of the vertical ear canal is resented so there is a direct opening into the horizontal canal?

A

Lateral wall resection

40
Q

What is a lateral wall resection used for?

A

Excising masses located in the lateral part of the ear canal
NOT for treatment of otitis externa

41
Q

What is a myringotomy?

A

Surgicla puncture of hte caudo-ventral tympanic membrane

42
Q

When do you perform a myringotomy?

A

Otitis media
Biopsy of a mass within the bulla

43
Q

When is a tympanostomy tube (grommet) placed?

A

Primary secretory otitis media (glue ear)

44
Q

What dogs get primary secretory otitis media (glue ear)?

A

Cavalier King Charles Spaniels

45
Q

What is a TECA?

A

Total ear canal ablation - removing the entire vertical and horizontal ear canals

46
Q

What is a TECA always performed alongside?

A

Bulla osteotomy

47
Q

When do you perform TECA surgery?

A

Chronic otitis externa
Neoplasm in horizontal ear canal

48
Q

What are complications of TECA surgery?

A

Facial nerve injury
Chronic sinus tract development - para-aural abcess
Wound breakdown, haemorrhage
Vestibular signs

49
Q

What is the prognosis of TECA surgery?

A

GOod for otitis externa if avoid complications
Mixed for neoplasia - guarded for SCC

50
Q

What is a ventral bulla osteotomy?

A

When the chamber of the bulla are opened and gently cleaned/flushed

51
Q

When is ventral bulla osteotomy performed?

A

For removal of nasopharyngeal polyps in cats

52
Q

What are some complications of ventral bulla osteotomy?

A

Horners
Vestibular disease
Polyp regrowth
Haemorrhage
Facial nerve damage

53
Q

What auricular nerve blocks can be used for ear disease/surgery?

A

Auriculotemporal nerve
Greater auricular nerve

CVSOH BVSc4 (86 decks)

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