Ear surgery (Yr4) Flashcards
what are the layers of the pinna?
skin, cartilage, skin
how should lacerations involving the cartilage of the ear be treated?
dogs… vertical mattress including one layer of skin and cartilage starting at the ear margin to get better apposition
cats… only suture skin starting with concave surface first
what causes an aural haematoma?
trauma such as head shaking/scratching
how can aural haematomas be treated medically?
drain then inject methylprednisolone (must be sterile to prevent abscess formation)
how can aural haematomas be treated surgically?
acute… stab incision at proximal and distal ends of cavity then lavage and place a drain
chronic… s-shaped incision on concave surface of pinna, drain and lavage, close with interrupted mattress sutures, bandage ear to head
when is surgical treatment indicated for otitis externa?
skin has irreversible changes
cutaneous fistulae develop
para-aural abscess develops
if there in otitis media/interna present
what are the three surgeries that can be performed for otitis externa?
lateral wall resection
vertical canal ablation
total ear canal ablation
what is the aim of a lateral wall resection?
improve ventilation to reduce humidity/temperature and allow easier administration of medicines
what complications could arise from a TECA?
horners syndrome (damage to sympathetic nerves within bulla)
facial nerve paralysis/paresis
haemorrhage from retroglenoid vein
para-aural abscess formation
reduction/loss of hearing
how does septic otitis media occur?
bacterial infection that has extended across the tympanic membrane (almost exclusively dogs)
what are the clinical signs of septic otitis media?
pain, altered head carriage, jaw pain, purulent discharge (some have facial paralysis and Horners syndrome)
what is used for diagnosis of septic otitis media?
clinical signs (pain, purulent discharge, altered head carriage)
bulging and colour change of tympanic membrane
myringotomy and aspiration of bulla content with cytology/culture
how is otitis media treated medically?
myringotomy and cannula placement to allow lavage with sterile saline (not antiseptics) then topical/systemic antibiotics
what are inflammatory polyps?
non-neoplastic masses formed from epithelium of the middle ear (almost exclusively in cats) typically due to infection that disrupts middle ear drainage to cause inflammation and proliferation of epithelium
when is surgery indicated for poly treatment?
if there are neurological signs of medical treatment has failed
