Exam 1 - Aural Hematomas Flashcards
what is an aural hematoma?
rupture of the small vascular branches perforating the pinnal cartilage (scapha) that happens when shearing forces created from head shaking or blunt trauma leads to blood pooling within the pinnal cartilage
what is the pathogenesis of an aural hematoma?
the central scaphal cartilage partially separates or delineates into medial & lateral halves
shearing forces created from head shaking or blunt trauma
rupture of the small vascular branches perforating the pinnal cartilage
blood escapes into the connective tissue gap between the medial & lateral cartilage resulting in hematoma formation
what are some underlying conditions may lead to aural hematomas in companion animals?
otitis externa due to bacteria, allergies, parasites (otodectes), yeast, & foreign bodies
regardless of underlying etiology, what is the reason for hematoma formation?
self-trauma
what is the appearance of an acute aural hematoma?
swelling & change in the ear carriage
what is the appearance of a chronic aural hematoma?
ear pinna deformation
what is considered to be the most definitive treatment for aural hematomas with good cosmetic results?
surgery!!!!!
how are mattress sutures with no stents used to correct an aural hematoma?
sutures are placed vertically for repair - they are placed through the cartilage without incorporating the skin on the convex surface of the ear or they may be full thickness
what is the teat cannula/penrose drain method used for aural hematomas?
if minimal fibrin is present, teat cannula can be used for aural hematoma repair - trim half of the collar of the cannula to allow the tube to rest comfortably against the ear
alternative - 1/4 fenestrated latex drain can be used the same way
what are the goals of treatment for an aural hematoma?
drainage of the hematoma/evacuating the clot & reduce the space created in the cartilage
prevent recurrence by placing a bandage
what are some examples of treatments used for aural hematomas?
intralesional corticosteroid therapy
aspiration followed with compression bandages
no treatment
passive drains - teat cannula/penrose drain
what veins are present in the ear? what arteries?
lateral & medial auricular vein
stylomastoid artery - medial, intermediate, & lateral auricular branch
what nerves are present in the pinna of the ear?
caudal internal auricular nerve, middle internal auricular nerve, & rostral internal auricular nerve
what surgical correction method was used for this aural hematoma?
mattress sutures with stents
how is a bandage applied to the head after a surgical correction of an aural hematoma?
short strips of tape are placed on the rostral & caudal margins of the convex surface of the pinna
use longer pieces of tape on the concave surface of the pinna so that these tape pieces contact the tape on the concave surface
place the ear over the top of the head & place a non-adherent pad over the incision
apply cast padding & kling over the ear & then use vetwrap or stockinette as an external layer
what is the purpose of using a jackson-pratt drain for treating an aural hematoma? what are the benefits of using this for treatment?
provides continuous suction to collapse the hematoma cavity
minimally invasive approach that reduces surgical trauma & deformity of the pinna secondary to scar tissue
