Head & Neck Flashcards
pinna lacerations are treated how?
clipped, cleaned, debridement. E collar so no further trauma develops. if you see the skin flapping away from underlying cartilage, you will need to suture it: can suture the perichondrium. be careful of ischemic necrosis if lacerations are horizontal (blood supply is vertical)
when the ___ is injured, the structural support of the pinna may be lost
cartilage
what causes an aural hematoma and what is the best way to treat?
caused by self trauma secondary to aural disease (atopy, otitis externa, yeast infection, etc). the animal then head shakes and scratches the ears, and the skin separates from underlying cartilage and blood accumulates in this gap. If you do nothing it will fibrose and lead to permanant deformation of the pinna
tx: fix the primary aural disease!!! then drain and infusion of steroid or oral steroids
OR serpentine incision to the cartilage with interupted sutures (left open)
14 month old DAH with a head tilt and head shaking, has been getting worse and worse. You see a red nodule in the left ear. whats going on here? how will you treat?
nasopharyngeal polyp
definitive dx is a biopsy
do cranial nerve testing (horners is possible)
tx: simple traction/avulsion (yank it out after putting sutures in), then give steroids
other options: endoscopic traction + curettage of remaining tissue, CO2 laser, open sx removal via ventral bulla osteotomy (VBO)
what are some complications of a VBO?
ventral bulla osteotomy
horner’s, vestibular dx, deafness, damage to nerves, chronic otitis media/interna
a dog comes to you with recurrent ear infections, head shaking and scratching. when you look at the ears they are incredibly hyperplastic, stenotic, red, and painful. what is this, what are your next steps?
this is end stage otitis externa
next steps: aural exam (try to open the jaw), neuro exam, check LNs bc it might be neoplasia, check the rest of the dog for allergies/skin lesions, ideally a head CT
what is the best surgical option for end stage otitis externa?
***total ear canal ablation and lateral bulla osteotomy (TECA-BO)–>this is the treatment of choice usually
60yo MN lab comes to see you with swellings in the cranioventral cervical region over the past few weeks. it is not painful. what are your differentials? what diagnostic would you like to do?
neoplasia, thyroid mass, abscess, salivary mucocele
FNA
how do you treat a sialocele? (salivary mucocele)
drainage alone doesnt usually get rid of it
surgical excision of the affected gland and duct complex! prognosis if excellent with surgery
if a patient has a sialocele, what will the FNA look like?
serosanguinous, mucusy, thick lookin stuff
a young puppy presents for coughing, gagging, nasal discharge from the nose after eating, and is a bit skinny. you identify palatoschisis on PE. what surgical options are there?
many options: overflapping, bipedicle flap, slipt u flap, combinations, etc
what are oronasal fistulas commonly caused by?
us! from removing teeth!
a 12yo FS DSH presents for polyphagia, weight loss, PUPD, vomiting and diarrhea. PE reveals palpable thyroid. differential? treatment?
feline hyperthyroidism, usually a benign bilateral tumor. surgery is no longer the treatment of choice but may be a good option depending on the cat
8yo golden with a palpable cervical mass, non painful. differential? treatment?
canine thyroid tumor, often malignant, many have a;ready metastasized at time of diagnosis. highly vascular and can cause major hemorrhage if biopsied.
7yo lab with hematuria, stranguira, pollakiuria. differential? treatment?
hyperparathyroidism.
can surgically remove the nodes, excellent prognosis.
