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RUSVM Small Animal Surgery 2017 > Head and Neck Surgery > Flashcards

Head and Neck Surgery Flashcards

1
Q

Mesial

A

Toward the midline of the dental arch- central incisor (rostral)

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2
Q

Distal

A

away from the midline (caudal)

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3
Q

Proximal

A

(contact) surface facing adjoining teeth

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4
Q

Interproximal

A

between proximal surfaces of adjoining teeth

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5
Q

Diastema

A

wider space between teeth

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6
Q

Rostral/caudal

A

structures on head (not the teeth)

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7
Q

Occlusal

A

chewing surfaces of molars

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8
Q

Apical

A

toward the root or away from the crown

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9
Q

Coronal

A

toward the crown

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10
Q

Gingiva

A

the only visible part of the periodontium in a normal mouth

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11
Q

What makes up the Periodotium?

A

Gingiva
Periodontal ligament
Cementum
Alveolar bone

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12
Q

Gingiva sulcus

A

potential space between tooth and gingiva

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13
Q

Junctional epithelium

A

at the base of the gingival sulcus

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14
Q

Pulp cavity

A

Pulp chamber + root canal

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15
Q

What is a transitional tooth?

A

a tooth that the front half comes in contact with the premolar and the back half is in contact with the upper molar

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16
Q

How many roots does the Canine molar have?

A

3

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17
Q

How many roots does the canine premolar have?

A

2

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18
Q

How many roots does the canine incisor have?

A

1

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19
Q

How many roots does the canine canine tooth have?

A

1

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20
Q

How many roots does the feline canine tooth have?

A

1

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21
Q

How many roots does the feline incisor have?

A

1

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22
Q

How many roots does the feline premolar have?

A

2

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23
Q

What are the periodontal ligament functions?

A

Attaches tooth to the alveolus
Absorbs shock from the impact of occlusal forces and transmits them of the alveolar bone
Supplies nutrients to alveolar bone and cementum via arterioles and drainage via venules and lymphatics
Provides tactile and proprioceptive information for coordination of mastication

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24
Q

What happens if the periodontal ligament ossifies?

A

osteoclasts can invade the tooth and remodel it into brittle bone rather than a flexible tooth full of dentinal tubules, this causes the roots to essentially disappear and the crown to break off since the tooth doesn’t flex when it chews on something solid

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25
Cingulum
The shelf on the palatal surface of the maxillary incisors where the mandibular incisors occlude or "rest"
26
What is the "mass" behind the incisors?
Incisive Papilla overlies the Vomeronasal Organ
27
What is located on each side of the Incisive Papilla?
Incisive Ducts
28
What is important about the Parotid Salivary Gland Papilla?
located about the 4th premolar and releases mineral rich saliva and makes tartar accumulate more quickly on this tooth than other teeth
29
What kind of fracture is very common in premolars?
Slab fractures
30
What creates Dentin?
Odontoblasts
31
What forms the enamel?
Ameloblasts
32
What forms the cementum?
formed by remanants of the dental sac on the outer dentinal surface of the root when the tooth is almost mature Produced throughout life by cementoblasts
33
How many deciduous teeth does a dog have?
28
34
How many Adult teeth does a dog have?
42
35
How many deciduous teeth does a cat have?
26
36
How many adult teeth does a cat have?
30
37
What number does the Canine tooth have in the Triadan system?
04
38
What number does the 1st Molar have in the Triadan system?
09
39
Retained Deciduous Teeth?
Caused by failure of the primary tooth's root to undergo resorption
40
What teeth are commonly affected with Retained Deciduous teeth?
Canine | Incisors
41
Base Narrow Canines
Retained deciduous canine teeth that cause the canine adult teeth to not flair out like they normally would and cause trauma to the hard palate
42
What causes Base Narrow Canines?
retained deciduous canines
43
Interceptive orthodontics
intentionally creating space for the tooth to come in to
44
Polydontia
Supernumerary Teeth
45
Where are supernumerary teeth most commonly seen?
Maxilla
46
What teeth are commonly supernumerary?
Incisors | Premolars
47
What is the problem with supernumerary teeth?
interfere with normal occlusion | cause overcrowding, malposition, malocclusion, or incomplete eruption of adjacent teeth
48
Fusion
joining of two teeth | one crown and two roots with one or two root canals
49
Germination
incomplete splitting into two teeth
50
Andontia/Oligodontia/Hypodontia
missing teeth
51
What is the rule of thumb for Andontia/Oligodontia/Hypodontia?
If deciduous tooth is congenitally absent, the adult tooth will also be missing
52
Malocclusion Class 1
Malpositioned teeth, jaw, length normal Anterior/posterior cross-bite Base narrow canines
53
Malocclusion Class 2
Mandibular Brachygnathism Parrot Mouth Overshot
54
Malocclusion Class 3
Mandibular Prognathism | Undershot
55
Anterior cross bite
One or more of the maxillary incisors are displaced toward the palate
56
Posterior cross bite
Maxillary premolars are lingual to mandibular premolars or molars
57
What is the treatment for Class 2 Malocclusions?
Extraction | Reduce the height of the crown so it does not impact the gum
58
Level Bite
Incisor crown meet causing a type of prognathism
59
Attrition
Pathologic abnormal wear on incisors commonly repaired by tertiary dentin
60
Wry Mouth
Unequal arch development due to trauma or inherited
61
Treatment of Malocculsions
``` Interceptibe orthodontics Exodontics Crown reduction Orthodontic Appliances Incline Planes ```
62
What does an incline plane treat?
Base Narrow Canines
63
What is the complications with an Incline Plane?
Mucositis
64
What causes impacted teeth?
lack of space in the dental arch or mal-alignment of the tooth bud
65
What causes impacted teeth?
Traumatic insult or extraction
66
What is a result of Impacted teeth?
Abscess or cyst formation
67
What is the treatment for impacted teeth?
extraction
68
What can cause Enamel Hypoplasia/Hypocalcification?
``` High fevers Distemper Periapical inflammation trauma of the permanent tooth bud endocrine dysfunction early in life ```
69
How do you treat Enamel Hypoplasia/Hypocalcification?
``` Focal-restore defect with composite Several teeth cap to prevent wear Extraction Crown ```
70
What is the pathophysiology of Enamel Hypoplasia/Hypocalcification?
Damage to ameloblasts during enamel development or exposure of enamel to corrosive material
71
Tetracycline Staining
Tetracycline given when teeth are developing will stain them yellow
72
What layer is affected with Tetracycline?
Dentin
73
What is the treatment for Tetracycline staining?
None
74
How do you avoid Tetracycline staining?
Use Doxycycline
75
What is the treatment for Attrition?
Orthodontic correction Crown reduction Extraction
76
Abrasion
Caused by abnormal contact with crown surface by foreign object
77
What is the treatment for Abrasion?
Remove offending objects | Monitor for pulp exposure and crown fractures
78
How does Dental Caries appear?
Brownish color | Soft leathery consistency
79
What is the treatment for Dental Caries?
Indirect or direct pulp capping Root canal Extraction
80
What are the clinical signs for Periapical infection?
``` Nasal disease Maxillary/mandibular abscesses Intraoral fistula Retrobulbar disease Pathologic fracture ```
81
Parulis
Draining tract associated with the teeth
82
What is the etiology of Gingival Hyperplasia?
Focal-due to periodontal disease Generalized- in boxers drugs
83
What drugs cause Gingival Hyperplasia?
Cyclosporine Calcium channel blockers Anticonvulsants
84
What is the treatment for Gingival Hyperplasia?
Remove excessive tissue to return sulcus depth to normal
85
What is the treatment for Gingival Hyperplasia?
try to recreate normal scalloped contour | Surgery
86
What is the post op care for surgery for Gingival Hyperplasia?
Analgesics decaffenated tea Chlorhexidine Oral rinses
87
Pulpitis
Inflammation of the Pulp Cavity
88
What is the treatment for Pulpitis?
Monitor Root Canal Extraction
89
Enamel infarction (Abraction)
Cracks in the enamel | No loss of structure
90
Enamel Fracture
Loss of enamel only
91
Tooth fracture Classification
Complicated crown fracture Uncomplicated crown/root fracture Complicated Crown/root fracture Root Fracture
92
Complicated crown fracture
Pulp cavity is exposed
93
Uncomplicated crown/root fracture
Pulp not exposed
94
Complicated crown/root fracture
Pulp exposed
95
How do you treat Root Fracture?
Extraction
96
How do you treat Enamel fracture, Uncomplicated fracture in teeth?
+/- indirect pulp capping | Crown restoration
97
How do you treat Complicated Fractures in teeth?
Vital pulpotomy root canal Crown restoration Extract tooth
98
What are the indications for Endodontics?
Fractured teeth Pulpitis Tooth luxation/avulsion Crown reduction
99
What are the advantages of Endodontics?
Less invasive than extraction Preserves tooth function and integrity of jaw more fun to do than extractions
100
What are the disadvantages of Endodontics?
Expense Longer anesthetic time Special instruments and training
101
What is the goal for Vital Pulpotomy?
to maintain a viable tooth that will continue to mature
102
When would you perform a Vital Pulpotomy?
Immature tooth Very wide pulp cavity Apex not completely closed
103
What do you use to seal a Pulpotomy?
MTA | Calcium hydroxide
104
When would you perform a complete root canal?
Mature tooth | Maintains tooth function but tooth is "dead"
105
What are the goals for a complete root canal?
Complete removal of pulp contents | Seal apex to prevent bacteria from escaping from tooth
106
How do you perform Root Canal Therapy?
1. Access the pulp cavity 2. Remove pulp through access site 3. Clean, disinfect and shape canal 4. Obturate the canal 5. Restore the surface of the crown and access site
107
How do you perform a Root Canal Obturation?
Complete filling of root canal seals apical delta and lateral canals preventing contamination in dentinal tubules from escaping from the tooth and causing inflammation/destruction of the tooth supporting structures
108
Tooth Luxation
partially dislocated from alveolus but retains some attachment
109
Tooth Avulsion
completely displaced from alveolus
110
What is the prognosis for Tooth Luxation/Avulsion?
After 30 mins success goes down exponentially | Success depends on survival of periodontal ligament
111
What is the treatment for an Avulsed Tooth?
keep the tooth moist with saliva, milk, or saline Flush the tooth with saline Re-seat in alveolus and then splint in place Root canal once the splint is removed and reattached Radiographs!
112
What are synonyms for Tooth Resorption?
Feline Odontoclastic Resorptive Lesions Neck Lesions Cervical Line Lesions Canine Odontoclastic Resorptive Lesions
113
Stage 1 Tooth Resorption
Mild dental hard tissue loss, either cementum alone or cementum and enamel. In this stage of the disease, a defect in the tooth's enamel is all that is usually noted Little to no sensitivity because the resorption has not yet reached the dentin
114
Stage 2 Tooth Resorption
Moderate dental hard tissue loss including cementum or cementum and enamel, and loss of dentin that has not yet reached the pulp cavity
115
Stage 3 Tooth Resorption
Deep dental hard tissue loss including cementum or cementum and enamel, and loss of dentin that extends to the pulp chamber, At this third stage of disease, most of the tooth is still viable
116
Stage 4 Tooth Resorption
Extensive dental hard tissue loss and most of the tooth has lost its integrity. A significant amount of the tooth's hard structure has been destroyed.
117
What are the stage 4 tooth resorption subcategories?
4a - crown and root of tooth are equally affected 4b - crown is more severely affected than the root 4c - root is more severely affected than the crown
118
Stage 5 tooth resorption
Only remnants of the tooth remain, covered by gum tissue. The majority of the tooth has been resorbed, leaving only a raised area on the gum
119
Type 1 Resorption Lesions
Focal or multifocal radiolucencies Periodontal ligament remains intact Moderate to severe gingivitis and periodontitis
120
Type 2 Tooth Resorption Lesions
Focal or multifocal radiolucencies in tooth Disappearance of the periodontal ligament with varying degreese of root resorption No or minimal evidence of periodontitis
121
Type 3 Tooth Resorption Lesions
Features of type 1 and 2 in same tooth - especially multi-rooted teeth
122
What is the treatment for type 1 tooth resorption lesions?
Extraction
123
What is the treatment for Type 2 tooth resorption lesions?
Remove the crown and let it resorb over time
124
What are the clinical signs of Tooth resorption?
``` inflammation pain Localized hyperplastic/hyperemic gingiva dropping food "chattering" anorexia reluctance to have mouth examined ```
125
Ankylosis
the process of bone fusing across the normally non-calcified periodontal ligament
126
What is the treatment for type 2 tooth resorption?
Extraction | Amputate crown and superficial root structure and leave ankyloid part of the root for resorption
127
What are the clinical signs of Gingivostomatitis?
``` Ptyalism Halitosis Dysphagia anorexia weight loss ```
128
Gingivostomatitis
Severe marginal gingivitis | Inflammation of the commisures, palatopharyngeal arches and caudally, and Palate
129
How do you diagnose Gingivostomatitis?
Histopathology Clinical appearance Typical History
130
What is the treatment for Gingivostomatitis?
``` Extraction Antibiotics Home care/Prophylaxis Cyclosporine Antivirals ```
131
What is important to note about Gingivostomatitis Extraction?
All teeth and roots must be extracted! They will not resolve!
132
What are the clinical signs of Juvenile-Onset Periodontitis?
Severe gingivitis | Periodontal disease
133
What is the treatment for Juvenile-Onset Periodontits?
Frequent Prophylaxis Aggressive home care Some will "outgrow" it if can get to 2+ yrs Extractions
134
What is the complications of Eosinophilic Granuloma Treatment?
A large blood vessel lives in the area of the granuloa causing severe hemorrhage
135
What is the treatment for Eosinophilic granulomas?
Ligating the blood vessel | removing the inflammatory tissue
136
What are the clinical signs of Canine Ulcerative Paradental Stomatitis?
Fetid Halitosis Ptyalism Anorexia
137
Treatment of Canine Ulcerative Paradental Stomatitis?
can try and control conservatively with sealant and teeth cleaning Home care - 1-2x daily brushing Total mouth extractions
138
When would you perform a Glossectomy?
Trauma Neoplasia Macroglossia
139
Partial Glossectomy
Removal of free portion of tongue rostral to frenulum
140
Subtotal Glossectomy
Entire free portion of tongue and rostral part of base of tongue caudal to frenulum
141
Total Glossectomy
Entire tongue
142
When would you perform a Total Glossectomy?
Lingual Squamous Cell Carcinoma
143
What are the postoperative managements for a glossectomy?
Feeding tube Feed "meatballs" Water: Provide wet food, may learn to suck water, syringe
144
What is the most common oral disease?
Periodontal disease
145
What is the number 1 causes of tooth loss?
Periodontal disease
146
What is the most common causes of periodontal disease?
Diet | Malocclusion
147
Acquired pellicle
a thin layer of salivary proteins on the surface of the tooth to which bacteria attach
148
Plaque
combination of bacteria, food, debris, oral epithelial cells and mucin
149
Calculus
mineralized plaque containing bacteria which release endotoxins that cause gingivitis
150
Gingivitis
initially loosely adhered subgingival plaque causes an inflammatory response which is reversible with proper treatment
151
Periodontitis
If left untreated the inflammatory response results in destruction of the junctional epithelium and epithelial attachment at base of the gingival sulcus exposing the periodontium
152
Xerostomia
Lack of saliva
153
What are the characteristics of Periodontal Disease?
``` Irreversible/controllable Gingival recession Destruction of periodontal ligament Bone loss Mobility ```
154
What are the clinical signs of Periodontal Disease?
``` Halitosis Accumulation of plaque and tartar Inflamed or bleeding gingiva Excessive salivation Loose teeth Decreased appetite Oral discomfort ```
155
What are the characteristics of Stage 1- Gingivitis?
``` Erythema Gingiva bleed when probed Loss of stipling Normal sulcus depth Reversible with proper treatment and home care ```
156
What are the characteristics of Stage 2- Early Periodontitis?
``` Gingiva bleed when probed Minor pockets Normal-hyperplastic Gingiva minimal bone loss no mobility Periodontitis can be controlled but not completely reversed ```
157
What are the characteristics of Stage 3-Moderate Periodontitis?
Gingival hyperplasia with recession moderate deep pocket formation 25-50% bone loss Slight to moderate mobility
158
What are the characteristics of Stage 4-Advanced Periodontitis?
``` Gingival recession Deep pocket depth Furcation exposure Greater than 50% bone loss Advanced tooth mobility Horizontal bone loss Vertical bone loss Periapical lucency ```
159
Feline buccal bone expansion
An expression of vertical pocket formation filled with granulation tissue and osteitis
160
What is the goad of treatment for Periodontal Disease?
prevent development of ew lesions at other sites and to prevent further tissue destruction at sites which are already affected Remove biofilm Minimize attachment loss and pocket depth Maintain adequate attached gingiva (2-3mm)
161
What is the treatment for Periodontal disease?
Home care - Brushing Dental Diets Dental hygiene chews
162
What is the #1 Systemic Antibiotic Therapy for Periodontal Disease?
Clindamycin
163
What are the Systemic Antibiotic Therapies for Periodontal Disease?
Clindamycin Clavamox Metronidazole Doxycycline
164
What is the Local Antibiotic Therapy for Periodontal Disease?
Doxirobe gel | Clindoral
165
What is the professional Periodontitis Therapy?
Supra- and sub- gingival scaling and polishing root planing extraction
166
Stage
The assessment of the extent of pathological lesions in the course of a disease that is likely to be progressive
167
Grade
The quantitative assessment of the degree of severity of a disease or abnormal condition at the time of diagnosis, irrespective of whether the disease is progressive
168
Index
A quantitative expression of predefined diagnostic criteria whereby the presence and/or severity of pathological conditions are recorded by assessing a numerical value
169
Periodontal Index
Measures the amount of overall tissue loss
170
Gingival recession
measures the apical migration of the free gingival margin from the cemento-enamel junction
171
Physiologic tooth mobility
normal tooth mobility within the periodontal ligament space
172
Pathologic tooth mobility
tooth movement in excess of physiologic mobility
173
Exodontics
Tooth Extraction
174
What are the indications for Exodontics?
``` Retained deciduous teeth Interceptive orthodontics Severe periodontal disease Non-vital teeth or fractured crown with root exposure Teeth undergoing resorption Malocclusion - interference Supernumerary teeth Impacted teeth ```
175
How do you perform a Surgical Extraction Technique?
Create a buccal (vestibular) mucoperiosteal flap | Elevate flap apically past juga if necessary
176
What are the two techniques for a buccal mucoperiosteal flap?
Envelope flap +/- vertical incision | Single pedicle flap
177
What is the Aftercare of Gingival Flaps?
Broad spectrum antibiotics Soft food No chew toys or heard treats Nothing with a crunch for 10-14 days
178
What are the clinical signs of Oronasal Fistula?
Nasal discharge Sneezing Aspiration pneumonia
179
How do you repair Oronasal Fistula?
Two layer technique | Single Flap technique
180
When would you use a Double Flap Technique to treat oronasal fistula?
congenital defects | Chronic fistulas where the oral mucoperioteum has healed to nasal mucosa
181
What are the indication for a Single Flap technique to treat oronasal fistula?
Acute nonhealed fistula | Defects too large to allow two layer closure
182
What are the salvage procedures for the treatment of oronasal fistula?
Intraoral appliances: Acrylic appliances or Nasal septal button
183
What are the triad of injuries associated with High Rise Syndrome?
Forelimb fractures or hyperextension injuries Facial trauma or fractures Thoracic trauma (Pneumothorax or cardiac contusions)
184
What is the treatment for hard palate trauma?
Conservative management Suture Acrylic splint between canine teeth + Suture Pin and Figure-8 wire + suture
185
What are the important malignant Canine oral tumors?
Malignant melanoma Squamous cell carcinoma Fibrosarcoma
186
Where does Multilobularostchondro-sarcoma (MLO) go?
Flat bones
187
Where do you find Undifferentiated Malignant Oral Tumor?
very aggressive tumor in the maxilla and behind the canine teeth
188
What are the benign Canine Oral tumors?
``` Peripheral Odontogenic Fibroma Acanthomatous ameloblastoma Osteogenic Odontoma Osteogenic Central Ameloblastoma Papilloma ```
189
What is the #1 Feline Oral tumor?
Squamous Cell carcinoma
190
What are the surgical principles of Oral tumors?
Wide margins Avoid use of electrosurgery on oral mucosa CO2 laser Avoid tension on oral closure Accurate apposition of oral mucosa essential
191
What suture material should you use for oral tumor closure?
Polyglactin 910 | Poliglecaprone
192
What is a Total mandibulectomy?
Removal of the left or right mandible
193
How do you treat Multilobularostchondro-sarcoma (MLO)?
Caudal Mandibulectomy
194
When performing a Total mandibulectomy what do you do to prevent the tongue from falling out?
Shorten the lip commissure
195
What are the different types of Mandibulectomies?
``` Unilateral Rostral Bilateral Rostral Central Total Caudal 3/4 ```
196
What are the different types of Maxillectomies?
Caudal Unilateral Rostral Bilateral Rostral Partial
197
What is the post operative care for a Mandibulectomy/Maxillectomy?
IV fluids for first 24 hours Pain medication drink and eat after surgery Feeding tube for 3/4 mandibulectomy
198
What are the complications associated with Mandibulectomies?
Swelling - pseudoranula un the tongue Wound dehiscence Mandibular drifting Affect the ability to prehend food
199
What are the complications associated with Maxillectomies?
Wound dehiscence with oronasal fistula | nose to droop and affect prehension of food
200
Labial Avulsion
lower lip avulses along the mucogingival line due to shearing trauma
201
What is the treatment for Labial Avulsion?
Suture reconstruction effective for maxillary lesions | Suture reconstruction of lower lip
202
What is a complications of the treatment for Labial Avulsion?
Weight of lower lip causes the suture reconstruction to fail
203
What are the reconstruction options for Lip reconstruction?
Direct apposition Labial advancement flap Labial rotation flap Labial advancement flap
204
What are the parts of the Sublingual Salivary Gland?
Monostomatic | Polystomatic
205
What are the four major salivary glands?
Parotid Mandibular Sublingual Zygomatic
206
What is the additional major salivary gland of cats?
Molar salivary gland
207
Salivary Mucocele
Subcutaneous accumulation of saliva within a nonepithelial nonsecretory lining
208
What is the most common disease of the salivary gland in dogs and cats?
Salivary Mucocele
209
What is the most common salivary gland affected by Salivary Mucocele?
Sublingual Monostomatic portion
210
What is a complication of a salivary mucocele?
respiratory distress
211
How do you diagnose Salivary Mucocele?
Aseptic needle aspiration
212
How do you treat Salivary Mucocele?
Removal Percutaneous aspiration "Marsupialization" of ranula Lancing of pharyngeal mucocele
213
What is the prognosis for a salivary mucocele?
Excellent | Recurrence can occur
214
What causes a Parotid Fistula?
Trauma to the Parotid duct
215
What is the treatment for a Parotid Fistula?
Ligation of the parotid duct proximal to the defect that is causing the fistula results in atrophy of the gland
216
What are the two types of Digital Dental Radiographic imaging systems?
Direct digital radiography | Indirect digital radiography
217
What are the intraoral techniques for Dental Radiographs?
Parallel | Bisecting Angle
218
What are the complications of the Bisecting Angle Dental Radiograph technique?
Elongation Foreshortening Overlapping
219
Aural Hematoma
collection of blood within the cartilage plate of the ear
220
What causes Aural Hematoma?
Shaking/Scratching of ear due to Otitis externa
221
What are the goals of surgery for Aural Hematoma?
Remove blood or clot Prevent reoccurrence Retain ear appearance
222
When would you use the non surgical treatment for aural hematoma?
recent and fluctuant hematomas | smaller hematomas
223
When would you use the surgical treatment for aural hematoma?
Chronic Hematomas | Harder to remove clot through aspiration
224
What allows a hematoma to reoccur?
Dead space left after surgery
225
What is the non surgical management for Aural hematoma?
Aspiration Aspiration with IV Dexamethasone Aspiration with local Dex infusion Aspiration with local Methyl Prednisolone
226
What is the surgical management for Aural Hematoma?
Drain placement Incisional Drainage Practivet system
227
What are the different types of Drains used in the surgical drainage of Aural Hematoma?
Penrose Larson teat cannula Butterfly catheter
228
What are the different types of Incisional drains used in the surgical management of Aural Hematomas?
Straight S-shaped Dermal punch Laser
229
What is the disadvantage of an incisional drainage associated with Aural Hematomas?
Reoccurence rates are less but this method requires general anesthesia
230
What is an advantage of using the Teat cannula to drain an Aural Hematoma?
will cause adhesions to form to reduce dead space
231
What type of suture is used with the Incisional Drainage associated with Aural Hematoma?
Vertical Mattress suture pattern
232
What is the treatment for Squamous Cell Carcinoma?
Pinnectomy +/- vertical ear canal ablation
233
What are the indications for Subtotal or Total Pinnectomy?
Neoplasia or trauma | Curative for SCC in cats
234
What are the primary causes for Otitis externa?
``` Parasites Foreign Body Hypersensitivities Keratinization disorders Autoimmune ```
235
What are the predisposing factors for Otitis externa?
``` Pendulous ears Narrow canals Excessive hair Chronic ear moisture Inappropriate abs Polyps or tumors ```
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What are the clinical signs of Otitis externa?
Head shaking rubbing scratching
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How do you diagnose Otitis externa?
``` Otoscopy Cytology Biopsy CT MRI ```
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What are the surgical procedures for Otitis externa?
Lateral ear canal resection Vertical ear canal resection Total ear canal ablation with lateral bulla osteotomy
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What are the indications for Lateral Ear canal resection?
when skin changes are reversible | Tumor involving tragus or lateral wall of vertical canal
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What is the advantage for Lateral ear canal resection?
Improves ventilation | Decreases moisture
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Describe Lateral ear canal resection
Remove proximal 2/3 of flap | Ventral 1/3 forms drainage board
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Describe the closure for a Lateral Ear canal resection?
Single layer closure using 3/0 monofilament
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What are the complications for Lateral Ear Canal resection?
Inadequate drainage Continued otitis externa concurrent middle ear infection
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What are the indications for Vertical Ear Canal resection?
Hyperplastic otitis involving vertical canal only Neoplasia involving vertical canal only Trauma
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Describe the Vertical Ear Canal Resection
T-shaped incision Dissect around cartilage Create drainage
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What are the indications for Total Ear Canal Ablation with Lateral bulla osteotomy?
Ceruminous gland adenocarcinoma Extensive benign otitis Failed lateral ear canal resection Middle ear disease
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Describe a Total Ear Canal Ablation
T-shaped incision Dissect around cartilage Amputate canal close to auditory meatus
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Bulla Osteotomy
Removal of soft tissue from lateral bulla
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What is a complication of performing a Bulla Osteotomy?
``` Damage to the sympathetic trunk causing Horner's Syndrome Facial nerve paralysis Diminished hearing Hemorrhage Dehiscence Infection/Drainage tract ```
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What is the medical management for middle ear disease?
Clean external ear Perform myringotomy Irrigate with saline Topical and systemic non ototoxic abs for 4-6 weeks
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When would you choose surgical management for Middle Ear Disease?
Severe canal stenosis Tympanic bone infection Failure of medical management Significant neurological signs
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Myringotomy
incision into the Tympanic Membrane
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When would you perform a Ventral Bulla osteotomy in a Feline?
when disease is confined to middle ear | Inflammatory polyps are present
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What do you perform on a feline with middle ear disease?
Ventral Bulla osteotomy | Lateral Bulla Osteotomy combined with TECA
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Middle ear Polyps
Non-neoplastic polyps developed from inflammatory and epithelial cells
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How do you manage polyps?
Traction extraction | Ventral Bulla osteotomy
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What are the complications of a Ventral Bulla Osteotomy?
Vestibular signs | Horner's Syndrome especially common in cats

RUSVM Small Animal Surgery 2017 (17 decks)

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