Ear Pathology Flashcards
What are the top ten canine claims?
- Atopic or allergic dermatitis
- Ear Infection
- Benign skin neoplasia
- Pyoderma
- Osteoarthritis
- Periodontitis/tooth Infection
- Upset stomach
- Intestinal inflammation/diarrhea
- Cystitis or urinary tract disease
- Anal gland sacculitis/ expression
The ear is the extension of?
The skin
Function of the Ear
The ear is the organ of _________ and _________
1. Collect _________ stimuli
2. Transduce the _________ stimuli
3. Transmit nerve impulses to _____
Function of the Ear
The ear is the organ of hearing and balance
1. Collect auditory stimuli
2. Transduce the mechanical stimuli
3. Transmit nerve impulses to CNS
Big ear, big oracle –> advantageous for this species
The ________ collects the sound. The external ear starts with the _____ –> external acoustic _______ which has the ______ and ______ part.
–> the external ear ends with the ________ _________.
The oracle collects the sound. The external ear starrs with the oracle –> external acousitic medius whihc has the vertical and horizontal part –> the external ear ends with the tympanic membrane.
Middle ear = tympanic cavity (tymanci bulla with cavity) including the ossicles (small bones in middle ear), auditory tube conects tot he pharynx whihc is apart of the middle ear.
Inner ear = cochlea, and the semi circular canals. These two components are within the inner ear. When you have otitis interna, these are the affected structures.
The vesibular and cochlear nerve connect to the vestibular aparatus and the cochlea. Whenver the animal has otitis interna, even otitis media, that extends into otiis interna there may be some nerve dmage that manifests as neuro disease (e.g. Horner’s)
The ear is composed of three major parts
1. External ear:
* _______ (or ______)
* ________ ________ _________
2. Middle ear:
* ?
* ?
* ?
* ? –> ?
3. Inner ear:
* Composed of a _________ labyrinth enclosed in the ________ bone.
The ear is composed of three major parts
1. External ear:
* Auricle (or pinna)
* External auditory meatus.
2. Middle ear:
* Tympanic membrane (ear drum)
* Tympanic cavity
* Auditory ossicles (malleolus, incus and stapes)
* Auditory (Eustachian) tube; connected to the pharynx
3. Inner ear:
* Composed of a membranous labyrinth enclosed in the temporal bone.
In external ear canal, there is _______ cartilage. Very ______. Very __. When animal has otitis externa, ear feels very ____ and _____ – proliferation of ______ and cartilage is ________.
In external ear canal, there is elastic cartilage. Very pliable. Very soft. When animal has otitis externa, ear feels very hard and stiff – proliferation of tissue and cartilage is ossified.
Components of the External Ear
* _________ skin –> any diseases of tegument system can occur here = ?
* ______ or _____
* ________ cartilage
* ________ ear canal/________ _______
* ________ membrane (________)
Functions of the External Ear
* ________ and _______ sound waves
Components of the External Ear
* Haired skin –> any diseases of tegument system can occur here = atopic dermatitis, pyoderma, otitis externa
* Auricle or Pinna
* Elastic cartilage
* External ear canal/auditory meatus
* Tympanic membrane (eardrum)
Functions of the External Ear
* Collect and convey sound waves
Label this image accordingly
Inflammation cna happen on both sides since hair on both side
Ceruminous Glands
* Located within the skin of the?
* Simple, ______, _____ ________ glands
* Secrete ear _____, also known as ________, is a mixture of viscous secretions from
________ glands, sloughed ____ cells, and less-viscous ones from modified
________ ______ glands (________ glands)
They become tumors: ?
Dx by _______. Mass in external ear canal.
Ceruminous Glands
* Located within the skin of the external acoustic canal
* Simple, coiled, tubular apocrine glands
* Secrete Ear wax, also known as cerumen, is a mixture of viscous secretions from
sebaceous glands, sloughed skin cells, and less-viscous ones from modified
apocrine sweat glands (ceruminous glands)
They become tumors: ceruminous adenocarcnimoma/adenoma. Dx by histopath. Mass in external ear canal.
Label the image accordingly
What is pictured below?
Ceruminous glands
Diagnostics for External Ear Diseases
Pinna & Wall of the Canal
* ________ examination –> make sure to do this;
- if see lesions, do _______!
* Cytology (________ smears and ____ preparations)
* _______ and _____ skin ______
* _________
* _______ and ______ culture and sensitivity
* Fine-______ aspirates
* ________
Diagnostics for External Ear Diseases
Pinna & Wall of the Canal
* Otoscopic examination –> make sure to do this;
- if see lesions, do cytology!
* Cytology (impression smears and tape
preparations)
* Superficial and deep skin scrapings
* Trichograms
* Bacterial and fungal culture and sensitivity
* Fine-needle aspirates
* Biopsy
Cytollogy = Neutrophils engulfing cocci (on left) –> pyoderma
deep- mites
tricho - hair follicle problem
bacterial - infectious agents on cytology
mass - fine needle
biopsy - mass
top left is impression smear
top right is tape
Pinna & Wall of the Canal
* Cytology (swab)
Numerous cocci, rods (red arrows) and Malassezia pachydermatis
(black arrow) are present
Adult mite and ovum of Otodectes cynotis
stray cat with itchy ears!
Otitis Externa
* Otitis externa is ________ a primary condition
- oftentimes animal will have ______ disease such as a ?
* Usually arises from the interaction of ________ factors, ______ causes, and ______ causes
* more common in ____»_space;» ____
* Clinical signs:
* Exudate, hemorrhage
* Auricles tend to be _____, _____, _______, and ________
* Chronic cases: ______ epidermis, _____ external ear canal, _______ (_______ of skin)
* If left untreated, ________ _______ of the ear canals will become necessary
Otitis Externa
* Otitis externa is rarely a primary condition
- oftentimes animal will have underlying disease.
- food allergy, ectoparasite infestation, etc.
* Usually arises from the interaction of predisposing factors,
primary causes, and secondary causes
* more common in Dogs»_space;» Cats
* Clinical signs:
* Exudate, hemorrhage
* Auricles tend to be red, warm, edematous, and painful
* Chronic cases: thickened epidermis, stiff external ear canal, stenosis (prolferation of skin)
* If left untreated, surgical removal of the ear canals will become
necessary
Predisposed to otitis externa b/c floppy ears, not much air flow, lot of hair
swimming also predisposes them
Predisposing Factors of Otitis Externa?
Christine’s TOEES
Obstructive: mass, polyp causes this too
Secondary causes of otitis externa
treat for seconary then investigate primary.
this is what you ususally see
Acute otitis
- diffusely errythematous
- pale yellow to brown exudate
do not see external ear canal anymore because it is stenotic.
- b/c skiin is proliferaing and cartilage is ossified
Looks bumpy, proliferation of tissue
eppidermas and extenal strutures become hyperplastic
Auricular Acariasis (Ear Mite Infestations)
- coffee ground like material
Auricular Acariasis (Ear Mite Infestations)
* Otodectes cynotis is a common cause of ______ _______ in cats and dogs
* Most common in ______, ____-roaming cats and dogs with ______ access
–> Clinical signs:
* _______, head ______, head ____, ______
* Dark “_______ ____ otic discharge
–> Diagnosis:
* ________ examination
* _________ examination of samples from the ears
Auricular Acariasis (Ear Mite Infestations)
* Otodectes cynotis is a common cause of otitis externa in cats and dogs
* Most common in young, free-roaming cats and dogs with outdoor access
* Clinical signs:
* Pruritus, head shaking, head tilt, circling
* Dark “coffee ground otic discharge
* Diagnosis:
* Otoscopic examination
* Microscopic examination of samples from the ears
white tan debris = mites
Otodectes cynotis Infestation in Cats
Psoroptes cuniculi infestation in a rabbit
Crusts in ear canal
Aural Plaques (Aural Papillomatosis)
- More common in horses > 1 y/o
- Cause: Equus caballus papillomavirus
- Clinical findings:
- Raised, well-demarcated, hypopigmented,
hyperkeratotic plaques arising from the concave
surface of the auricle - well demarcated
- especially found in concave surface of ear
Canine Leproid Granuloma
* Cause: novel mycobacterial species. (unknown specifics yet)
* Most commonly affects short coated large
breeds such as Boxers
* Pinnae
* Single to multiple well circumscribed, firm,
nonpainful dermal nodules
* Pyogranulomatous dermatitis with
intralesional acid-fast positive bacteria
Ischemic Dermatopathy
* ______ and _______ poodles, ________, _________, ________ terriers and _____ _______ terriers were over-represented
* ~50% of cases associated with _______ (e.g. ____)
- other 50 not!
* Lesion location:
* Most commonly at _______ sites, _____, ________/face, and _____ extremities
Ischemic Dermatopathy
* Toy and miniature poodles, Chihuahuas, Maltese, Yorkshire terriers and Jack Russell terriers were over-represented
* ~50% of cases associated with vaccination (e.g. rabies)
- other 50 not!
* Lesion location:
* Most commonly at vaccine sites, pinna, periocular/face, and distal extremities
Ischemic Dermatopathy
Lesion characteristics?
* Scalloped and notched ear margin
- b/c poor _____ supply –> _______ of ear tip
Ischemic Dermatopathy
Lesion:
* Alopecia, crusts, scale, erythema,
erosion/ulcers, hyperpigmentation.
* Scalloped and notched ear margin
Localized parakeratotic hyperkeratosis in
Boston Terriers
* Usually seen in Young ______ terrier (Median age of onset: ____months)
* Mild to severe ________ ________ of the _____
- Histologically, looks like ____ responsive keratosis in huskies;
* Some of the cases improved with oral ____ supplementation
Localized parakeratotic hyperkeratosis in
Boston Terriers
* Young Boston terrier (Median age of onset: 3.5 months)
* Mild to severe parakeratotic hyperkeratosis of the pinna
- Histologically, looks like zinc responsive keratosis in huskies;
* Some of the cases improved with oral zinc supplementation
Folded Ear Tip in Cats
* Associated with long-term glucocorticoid therapy
can’t be reversed, even if you take them off steroids
Aural Hematomas
* Most common in _____, _____, _____
* Large-breed dogs, in particular ?
* Risk factor: _______ ear disease - e.g. ?
* Pathogenesis:
* Chronic _______ or _______ ear disease →
continuously and vigorously _____
heads → trauma to blood _____ and
auricular ______ at the _____ and _____ of
the auricles → aural ________
Aural Hematomas
* Most common in dogs, pigs, and cats
* Large-breed dogs, in particular golden
retrievers and Labrador retrievers
* Risk factor: Ongoing ear disease
- e.g. otitis externa
* Pathogenesis:
* Chronic external or middle ear disease →
continuously and vigorously shaking
heads → trauma to blood vessels and
auricular cartilage at the sides and tips of
the auricles → aural hematoma
there is only one aural cartilage but then in this case it broke apart! and now there is 2
Feline Ceruminous Cystomatosis
* Cause ________
* More common in ______ cats
* ______ predisposition
* ________ and ________ predisposed; unclear as to why
* Lesion:
* _______, _______ nodules or vesicles that
are dark ______, ______, or _______ colored.
* External ear canal, eyelids, lips, or inner
pinnae/outer ear canals
* Diagnosis: Biopsy
- benign condition but animal can trauamtize, CO2 lazor ablasion to get rid of. Make sure to boopsy to make sure ther is no neoplasia
Feline Ceruminous Cystomatosis
* Cause unknown
* More common in older cats
* Male predisposition
* Abyssinian and Persian predisposed; unclear as to why
* Lesion:
* Multiple, small nodules or vesicles that
are dark brown, blue, or black colored.
* External ear canal, eyelids, lips, or inner
pinnae/outer ear canals
* Diagnosis: Biopsy
- benign condition but animal can trauamtize, CO2 lazor ablasion to get rid of. Make sure to boopsy to make sure ther is no neoplasia
Aural Squamous Cell Carcinoma in Cats
predisposing factors:
1. White cats
2. Sunlight exposure!
What is pictured below?
Ceruminous adenoma: Single to multiple, small, pedunculate, irregular, and firm masses
What is pictured below?
- Ceruminous adenocarcinoma: Locally invasive; 50% metastasize to
regional lymph nodes, lungs, visceral organs
Ventrally there is a small extension of the neoplasm (asterisk) either through or between overlapping layers of auricular and annular cartilage
different behavior from adenoma
Label accordingly
adjacent to tympanic bulla is facila nerve
otitis media –> damage to facial nerve –> facial paralysis
- Middle ear Components?
- Middle ear Function?
- Tympanic membrane (ear drum)
* Tympanic cavity
* Auditory ossicles (malleolus, incus
and stapes)
* Auditory (Eustachian) tube
- Tympanic membrane (ear drum)
- The vibration of sound on the tympanic membrane is transmitted through the middle ear to the cochlea (inner ear) via the ossicles
See exudate –> culture
Otitis Media
* More commonly seen in ? But, ?
* A result of nasopharyngeal ascent of bacteria through the ?
* Etiologies:
* Pigs: ?
* Ruminants: ?
* Gross findings:
* __________ to ________ exudate in the bulla
* Chronic lesions – _______ of bone –> see fibrosis, _________ tissue
Otitis Media
* More commonly seen in Ruminants, pigs. Any animal can get it.
* A result of nasopharyngeal ascent of bacteria through the
auditory tubes.
* Etiologies:
* Pigs: Pasteurella multocida, Trueperella pyogenes, and Mycoplasma
hyorhinis
* Ruminants: Histophilus somni, P. multocida, T. pyogenes, Mycoplasma
bovis, and Streptococcus spp.
* Gross findings:
* Fibrinopurulent to caseous exudate in the bulla
* Chronic lesions – remodeling of bone –> see fibrosis, granulation tissue
Aural Inflammatory Polyp
(Nasopharyngeal Polyps)
* Most common in young _____ (<____ y/o)
* Originated from _____ ear ________, possibly the auditory _____ mucosa or ______ ____ dermis (rare)
* Can evert through the auditory tube into the __________ (“?”) or perforate the ________ membrane (“_____ _____”)
* Clinical signs depend on the ________
* Otitis ______ or otitis ______
* If extends to _________ : Nasal, otic, or ocular discharge; sneezing; dyspnea; stridor; voice change; dysphagia;
head tilt; Horner’s syndrome; nystagmus; and ataxia.
Depends on where polyp is for clinical signs
Aural Inflammatory Polyp
(Nasopharyngeal Polyps)
* Most common in young cats (<2 y/o)
* Originated from middle ear mucoperiosteum, possibly the auditory tube
mucosa or external ear dermis (rare)
* Can evert through the auditory tube into the nasopharynx (“nasopharyngeal
polyps”) or perforate the tympanic membrane (“aural polyps”)
* Clinical signs depend on the location
* Otitis externa or otitis media
* If extends to pharynx : Nasal, otic, or ocular discharge; sneezing; dyspnea; stridor; voice change; dysphagia;
head tilt; Horner’s syndrome; nystagmus; and ataxia.
Depends on where polyp is for clinical signs
Aural Inflammatory Polyp
(Nasopharyngeal Polyps)
Otoscopic view of a cat with
an inflammatory polyp.
Aural Inflammatory Polyp
(Nasopharyngeal Polyps)
can be taken out with forceps if small, but otherwise is surgically removed if larger.
can grow back
small balls on either side of CT are tympanic bulla. Should normally be clear, but if has polyp it will not be clear
Inner Ear
Component:
* Cochlea (the organ of hearing)
* Vestibular system (the organ of balance)
inner ear is closely associated with CN 8 –> damage to CN 8 is horner’s syndrome
Vestibular Apparatus (Organ of balance)
* Component:
* Utricle
* Saccule
* Semicircular ducts
* Within these are specialized structures
containing neuroepithelial cells
(sensory cells)
* Macula utriculi
* Macula sacculi
* Crista ampullaris
cochlea has stria vascularis –> produces endolympht that circulates in cochlea
Cochlea
* Tectorial membrane – vibrated by sound wave energy
* Organ of Corti – transduce sound vibrations into neural signals
* Basilar membrane – vibrated by sound wave energy
* Stria vascularis – produces endolymph
Hereditary Deafness
* Hereditary deafness is the most common cause of
deafness in dogs and cats and should be the first
differential diagnosis considered in an animal with
any white pigmentation.
* Dogs with the piebald or merle genes and blue-
eyed white cats
* Associated with hypopigmentation and stria
vascularis dysfunction.
Vestibular Disease of the Internal Ear
* Injury to any portion of the vestibular
system leads to vestibular disease.
* Type
* Central vestibular disease: dysfunction of
brainstem or cerebellum
* Peripheral vestibular disease: dysfunction
of CN VIII (vestibular nerve) or internal ear.
* Commonly due to concurrent otitis media
and otitis interna
* Can be idiopathic in cats and dogs
Vestibular Disease of the Internal Ear
* Clinical sign
* Head tilt, circling, ataxia, nystagmus
* +/- Horner’s syndrome (constricted pupil, elevated third eyelid, sinking of
the eyeball into the body cavity, drooping of the upper eyelid)
Horner’s syndrome in
the right eye of a cat
otitis media or interna affecting the cat –> horner’s
