Exam 3: Lecture 16 - Surgery of the ear

Question 1

what is the definition of otitis media

Answer 1

inflammation of the tympanic cavity and membrane

Question 1

what is the definition of otitis externa

Answer 1

inflammations of the vertical or horizontal ear canal or both

Question 2

what is the definition of otitis interna

Answer 2

inflammation of the inner ear that typically causes vestibular disease in dogs and is nearly always caused by extension of infection into petrosal bone from otitis media

Question 3

what is the definition of presbycusis

Answer 3

term used to describe age-related hearing loss

Question 4

what should we always ask owners prior to doing surgery on the ear

Answer 4

ask about their perception of the dogs hearing before sx!!

Question 5

T/F: total ear canal ablation (TECA) may diminish hearing and may be unacceptable

Answer 5

true!

Question 6

how can we decrease owner dissatisfaction after ear sx

Answer 6

be sure to tell owner / make sure they are aware of the dogs hearing deficits prior to sx

Question 7

T/F: Most owners of dogs with severe chronic otitis externa or media do not report substantial changes in their pets hearing after a TECA

Answer 7

true!

Question 8

T/F: pain management should be fully integrated into every phase of diagnosis, treatment, and recovery because ear disease and surgical intervention is VERY painful

Answer 8

true!!!

Question 9

how can we control pain for ear surgery

Answer 9

1. local anesthetics (splash blocks)
2. postoperative analgesia via the constant-rate delivery catheter

Question 10

what is important to remember for a vet picking a pain scale

Answer 10

must find one that the staff may be able to utilize quickly, easily, and consistently

Question 11

T/F: sicker patients may need additional monitoring of oxygen saturation, pulse, and BP once we give sedatives

Answer 11

true!

Question 12

what are the 3 parts of the ear

Answer 12

inner ear, middle ear, external ear

Question 13

what makes up the inner ear

Answer 13

a membranous and bony labyrinth and functions for healing and balance

Question 14

what makes up the middle ear

Answer 14

it is formed by the tympanic cavity and connects to the pharynx via the auditory tube (eustachian tube)

Question 15

what makes up the external ear

Answer 15

formed by the auditory meatus and a short canal

Question 16

what separates the middle and external ear

Answer 16

tympanic membrane

Question 17

what is the opening of the horizontal canal into the middle ear called

Answer 17

external acoustic meatus

Question 18

how does the middle ear connect to the nasopharynx

Answer 18

the auditory tube (eustachian tube)

Question 19

T/F: nasopharyngeal polyps may extend from the nasopharynx into tympanic cavity and can extrude into the external ear canal

Answer 19

true!!

Question 20

how is the feline tympanic cavity divided

Answer 20

it is divided into 2 compartments by a thin bony septum

Question 21

T/F: for complete drainage of the middle ear in cats, the bony septum often needs to be perforated

Answer 21

TRUE!!

Question 22

what is the promontory of the ear

Answer 22

there are post-ganglionic sympathetic nerves that form a plexus

Question 23

T/F: The nerves in the promontory are often traumatized during surgical curettage of the feline middle ear, causing horner’s syndrome

Answer 23

TRUE

Question 24

what are the clinical signs of Horner's syndrome

Answer 24

1. drooping of the eyelid on the affected side (ptosis) 2. pupil of the eye affected will be constricted (miosis) 3. affected eye often appears sunken (enophthalmos) 4. prominent third eyelid

Question 25

what are the 8 clinical signs associated with facial nerve paralysis

Answer 25

1. diminished palpebral reflex 2. widened palpebral fissure 3. drooping of the ear and lip 4. excessive drooling 5. blepharospasm 6. elevation and wrinkling of the lip 7. caudal displacement of the labial commissure 8. elevation of the ear on the affected side

Question 26

T/F: facial nerve paralysis and horner's syndrome may be caused by otitis interna, otitis media, or surgery

Answer 26

very true!

Question 27

what are the 4 important landmarks of the base of the ear that we should know for surgery

Answer 27

1. tragus 2. lateral crus of the helix 3. pretragic incisure 4. intertragic incisure

Question 28

what are the 3 surgical techniques for surgery on the ear

Answer 28

1. lateral ear canal resection 2. vertical ear canal ablation 3. total ear canal ablation-lateral bulla osteotomy (TECA-LBO)

Question 29

what are the characteristics of a lateral ear canal resection

Answer 29

1. increases drainage 2. improves ventilation of ear canal 3. facilitates placement of topical medications

Question 30

when is a lateral ear canal ablation indicated

Answer 30

when there is minimal hyperplasia of the ear canal epithelium or small neoplastic lesions of the lateral aspect of the vertical canal

Question 31

when is a lateral ear canal resection contraindicated

Answer 31

1. obstruction or stenosis of the horizontal ear canal 2. concurrent otitis media 3. severe epithelial hyperplasia

Question 32

dogs with what underlying diseases often respond poorly to a lateral ear canal resection

Answer 32

hypothyroidism and primary idiopathic seborrhea

Question 33

T/F: most studies have shown owner satisfaction to be low when lateral ear canal resection is performed for chronic otitis externa

Answer 33

TRUE!!!

Question 34

what is a zep procedure

Answer 34

modification of the original lateral ear canal resection technique which forms a drain board to restrict hair growth at the horizontal canal opening

Question 35

what procedure is this a picture of

Answer 35

zep procedure

Question 36

what procedure is shown in the picture

Answer 36

lateral ear canal resection

Question 37

what is VERY important to talk to the client about when performing a lateral ear canal resection

Answer 37

make sure the owner understands that lateral ear canal resection is not a cure and that medical management of the ear probably will be necessary for the remainder of the animals life

Question 38

when do we perform a vertical ear canal ablation

Answer 38

when the entire vertical canal is diseases but the horizontal canal is normal

Question 39

in what patients is a vertical ear canal ablation used

Answer 39

neoplasia is confined to the vertical canal or in some animals with chronic otitis externa

Question 40

what are benefits of the vertical ear canal ablation compared to a lateral ear canal ablation

Answer 40

1. may result in less postoperative exudation and pain 2. may provide a better cosmetic appearance of the ear

Question 41

what procedure is this a picture of

Answer 41

vertical ear canal ablation

Question 42

what are 3 complications of the lateral ear canal resection or vertical ear canal ablation

Answer 42

1. inadequate drainage and continues otitis external 2. clinical signs may not be relieved in dogs with underlying dermatologic disease that cannot be effectively managed 3. if drainage is insufficient, the result is persistent or recurrent signs of otitis externa

Question 43

T/F: facial nerve palsy is a rare complication of vertical ear canal ablation

Answer 43

TRUE!!

Question 44

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