Otitis Flashcards
which nerves are inside the middle ear of cats?
cranial sympathetic cervical nerves
what are the predisposing factors for otitis?
narrow ear canal
pendulous ear pinnae
iatrogenic factors
many hairs in ear canal
frequent swimming
what are the common primary causes of otitis?
parasites (Otodectesm, Demodex)
allergies (food vs environmental)
neoplasia/polyps
foreign bodies
what are the perpetuating factors of otitis?
microbial infection
chronic changes of the ear canal
otitis media
what are the majority of otitis media cases in dogs from?
chronic otitis externa
who is otitis media more likely to happen in?
dogs:
chronic>acute otitis
bacterial>yeast infection
rods>cocci>yeast
brachycephalic dogs
which types of dogs are predisposed to otitis media?
brachycephalic dogs
what is the most common cause of recurrent otitis in dogs?
allergy
what are the signs of otitis externa?
pruritus
erythema
edema
prominent discharge/waxy debris
pain
odor
hearing loss
what are the signs of otitis media?
horner’s syndrome
facial nerve paralysis
hearing loss
dogs: usually purulent otitis externa
not all/any signs might not be present
what are the signs of otitis interna?
head tilt
keratoconjunctivitis sicca
nystagmus
hearing loss
circular movement towards affected ear
ataxia
what should you pay close attention to in the ears of a dog with otitis?
any pain?
discharge
ear canals condition
ear drums condition
what should you treat otitis in the external ear canal with?
only topical antimicrobials
clean ear canal
what is a biofilm?
dense interaction accumulation of microbes
extracellular matrix that is composed ot extracellular polymeric substnaces
is culture and sensitivity helpful for otitis externa?
not really
what is the best long term management of allergic otitis?
topical steroid ear drops twice a week
topical tacrolimus: compounded ear solution
what can you do if there are non-reversible changes to the ear canals (like mineralization)?
total ear canal ablation with bulla osteotomy
what should you clean the ears with if there is purulent discharge?
saline
+/- n-acetylcysteine
what medications are safe for the middle ear?
fluoroquinolones
rifampin
ceftazidime
silver sulfadiazine (SSD)
water-based steroids
azoles, nystatin
squalene, triz-EDTA
what medications should you give if the tympanic membrane has been perforated?
ear drops based on cytology:
do not use dense
steroids
systemic antibiotics based on culture and sensitivity
what medications are typically indicated if the tympanic membrane is not visualized, and there are signs of otitis media/interna?
systemic antibiotics
systemic steroids
what are possible causes of otitis media/interna signs if the tympanic membrane is intact?
polyp/neoplasia in middle ear
primary otitis media
was a past tympanic membrane perforation that healed, but middle ear infection still present
what should you do if there are otitis media signs without polyp or neoplasia with intact tympanic membrane?
myringotomy with deep ear flush and culture and sensitivity of middle ear
ventral bulla osteotomy with middle ear flush and culture and sensitivity from middle ear
is microbial infection the cause of otitis?
no- never
what is the septum bulla like in feline and canine ears?
feline: almost completely divides middle ear into dorsal and ventral compartments
canine: incomplete, small shelf
how do the cranial nerves and the middle ear differ between feline and canine ears?
feline: cranial sympathetic cervical nerves travel through middle ear
canine: cranial sympathetic cervical nerves are outside middle ear
how often does otitis media develop in chronic canine otitis externa?
50%
when is otitis a diagnosis, not a symptom?
parasites
foreign body
neoplasia
congenital conformational changes: ear canal atresia
when might culture and sensitivity be needed for otitis externa?
Pseudomonas infection
otherwise not very helpful
what do you need in most cases of otitis externa to reduce inflammation and stenosis/proliferation?
topical steroids
what should you give for yeast infection in otitis externa?
azoles
nystatin
terbinafine
what should you avoid using if the ear drum is ruptured?
dense ointment-type ear drops
who is predisposed to primary secretory otitis media?
cavalier king charles spaniel
possibly brachycephalics
what are the clinical signs of primary secretory otitis media?
head/neck pain
spontaneous vocalization
neurological signs
pruritus around ears without otitis externa
hearing loss
lethargy
how can you manage primary secretory otitis media?
tympanostomy tubes
tympanostomy and middle ear flush
what is ceruminous cystomatosis?
non-neoplastic or benign
blue cysts on ear
