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small animal surgery > ear > Flashcards

ear Flashcards

1
Q

discuss contamination of surgical field of the ear

A

rather than perform repeated lavage of the external ear canal it would be better to accept that eural surgery is a contaminated procedure. hence perioperative antibiotics are indicated.

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2
Q

four landmarks your should remember

A

anthelix

tragohelicine incision

intertragic incision

tragus

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3
Q

reasons for doing surgery in the ear

A

otitis extena

strictures of the ear canal

neoplasia of the ear canal

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4
Q

how to evaluate the ear tympanum

A

remmber ear goes from vertical to horizontal .

needto have a straight line to evaluate the tympanum,

pull the aer down

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5
Q

reasons for doing surgery of the external ear

A

otitis externa

neoplasia of the external ear

strictures of the ear canal

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6
Q

causes of the otits externa

A

bacteria and fungus

malasezia is the most common cause

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7
Q

how to tx acute otitis externa

A

treat medically

claen ear before topical therapy

systemic antibiotics if indicated for 3 wks

tx for fungual or mites infection for 3-4 wks

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8
Q

tx for chronic otits externa

A

surgery

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9
Q

procedure for evaluating the ear canal

A

otoscopy

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10
Q

surgical procedure of the ear canal

A

lateral ear canal resection

vertical ear canal resection

total ear canal ablation, combined with lateral bulla estatomy(TECA LBO)

LaCroix can give u better access to the horizontal portion and better accessibility to tx the dz ear.

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11
Q

if u hav a dog that comes with the stenotic nares chronic infection and fluid in bulla .which tech, will u use

A

TECA-LBO

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12
Q

how to deal with otitis externa with epithelial hyperplasia

A

an otoscopy wont pass

can eliminate the coliflower

doing a culture is pointless because u can hav many bacteria there

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13
Q

discuss sx procedure for total ear canal ablation with lateral bulla osteotomy

A
  • begin with vertical ear canal resection
  • continue by removing horizontal canal-use rongeurs to remove medial bony portion
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14
Q

discuss the procedure for lateral ear canal resection

A

pg 157 on text book

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15
Q

when is lateral ear canal indicated vs vertical

A
  • in patients with minimal hyperplasia of the ear canal epithelium or small neoplastic lesions of the lateral aspect of the vertical canal
  • note that for the vertical ear canal its performed when the entire vertical canal is diseased but the horizontal canal is normal .it may be a tech. of choice if the vetical canal has neoplasia or animals witth chronic otitis externa
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16
Q

discuss the procedure for vertical ear canal ablation

A

page 159 textbook

17
Q

when do u do total ear canal ablation

A

whn animal has chronic otitis externa in which appropriate medical management has failed

when there is severe calcification

or the epithelial hyperplasia extends beyond the pinna or vertical ear canal

it is performed in animals with failed vertical ear canal resection

18
Q

when is lateral bulla osteotomy(LBO) performed

A

it is done to expose the tympanic cavity so that exudate and secretory epithelium can be removed which improves drainage

it should be performed with total canal ablation in animals with chronic otits externa and middle ear dz

19
Q

hen doing the TECA- LBO what precauton should u take

A

identify the facial nn. and pass around the umblical tape and pull to the side so u dnt damage the facial nn.

scrap the osseus bulla towards yourself so u dnt damage the tiny ear bones that u need to keep while removing the pierce of the auditory canal.

flash and aspirate any content of the osseus bulla

20
Q

n do u removes sutures after doing TECa/LBO

A

14 days

21
Q

which needle should u use for cannula drainager drainage

A

reverse cutting needle

22
Q

when should u remove canula in hematoma drainage

A

7-21 days

23
Q

when using an s or eliptical incision to drain the hematoma,how should u suture the lesion

A

suture has to go parallel to the incision.if u go horizontal,u will occlude the blood vessesl

stagger the suture.the point is that u wanna get the skin to adhere to the cartilage of the pinna

24
Q

discuss the consequences for failure to tx the aural hematoma or post management

A

will result in permanent deformity of the ear

coliflower

25
Q

list the surgical dz of the middle ear

A

neoplasia

otitis media

nasopharyngeal polyp–occurs in cats

N.B in dogs,otitis media may be a continuation of the otitis externa while in cats it can be primary

26
Q

cs of otits media

A
  • head tilt esp if associated with nystagmus, cycling , vestibular dysfunction
  • facial nn. deficits
  • nausea
  • vomiting
  • horners syndrome
  • myosis,potrution of the 3rd eyelid,ptosis of the upper eyelidenophalmosis
    *
27
Q

dx for otitis media

A
  • cs
  • examination of the tympanic bulla
  • skull radiographs
  • evaluation of the oral cavity and external ear for polypops
28
Q

indication for bulla osteotomy

A
  • otitis media
  • nasopharyngela polyp
  • neoplasm of epithelium of bulla
29
Q

discuss the surgical approach procedure for draining bulla and middle ear canal

A
  • ventral midline incision
  • trace a ventral line between a jajularvein and midline
  • make a parallel incision to the horizontal portion of the mandible.
  • surface of the bulla can be shiny or smooth unless there is some type of chronicity
  • will feel elevation when u stick a finger down..thats a bulla
  • make a whole into it and scrape it gently
  • lavage it and place a drainage if u hav to
30
Q

ddx for inflamed and hyperplastic epithelium of bulla

A

nasopharyngeal polyp

project into the pharynx thru the auditory tube

may cause dysnea,dysphagia

remember u hav to remove the stalk of the polyp coz if u dnt it will regrow

31
Q

discuss how nasopharyngela polyp is spread

A

may spread throughout tear in eardrum into the external eear canal

affects young cats and may be associated with respiratory viral infections

must be differentiated from neoplasia

32
Q

discuss ventral bulla osteotomy in removal of nasopharyngeal polyp

A

polyp may be pulled back into bulla and removed with epthelium

if polypop resected in pharynx or external ear canal,stalk should be pulled into bulla and removed with epithelium

33
Q

discuss how polyp stalks are removed

A

polyps are not remove per os.have to go into ventral bulla osteotomy

34
Q

complications of the ventral bulla osteotomy

A
  • horney;s syndrome esp common in cats.usually resolves in 2-3 weeks
  • facial nn. paralysis
  • vestibular dysfunction
  • superficial wound infection

small animal surgery (7 decks)

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