SA Ear and Pinna Surgery

Question 1

What is an aural haematoma?

Answer 1

Warm, fluctuant blood-filled swelling on the inner surface of the pinna.

Question 2

List four methods of conservatice treatment of an aural haematoma

Answer 2

Benign neglect
Daily systemic corticosteroids
Aspiration +/- flushing +/- intralesional injection of corticosteroids
Small incision and place haematoma tube

Question 3

Why is benign neglect of an aural haematoma not a suitab;e option?

Answer 3

Fluid resorption, fibrosis, contraction leading to malformation of the pinna and then pinna malformation increases the risk of future otitis.

Question 4

List four complications associated with a GA and ear flush

Answer 4

Iatrogenic damage to TM
Neurological damage
Irritation/damage to inflamed ear canal tissue
Aspiration of fluid

Question 5

Why is a GA required for an ear flush?

Answer 5

An ear flush must be performed using a GA due to the risk of aspiration.

Question 6

Which sutures may you use for a pinna repair and why?

Answer 6

Vertical mattress suture and a figure of 8 suture.

Question 7

What is a lateral wall resection and what are the indications?

Answer 7

The lateral part of the vertical ear canal is resected to create a direct opening into the horizontal canal. Excision of benign/malignant mass lesions located near the lateral part of the vertical ear canal.

Question 8

What is a myringotomy and what is it used for?

Answer 8

Surgical puncture of the caudo-ventral tympanic membrane, to relieve pressure/obtain diagnostic samples/facilitate flushin and instillation of topical treatments.

Question 9

List two indications of a myringotomy

Answer 9

Otitis media
Biopsy of mass within bulla.

Question 10

What is the indication for a tympanostomy tube placement (Grommet) and what breed of dogs is this used most commonly in?

Answer 10

Primary secretory otitis media. This is a disease reported in CKCS.

Question 11

Which procedure is TECA always performed in conjunction with?

Answer 11

Lateral/ventral bulla oseotomy

Question 12

What are the two most common serious complications of TECA surgery?

Answer 12

Facial nerve (CNVII) injury - common
Chronic sinus tract development (aka para-aural abscess) - most common

Question 13

What can a ventral bulla osteotomy be used for in cats as a standalone procedure?

Answer 13

For removal of nasopharyngeal polyps

Question 14

List two nerves which are blocked in ear surgery?

Answer 14

Auriculotemporal nerve
Greater auricular nerve