Small Animal Surgery Ear Flashcards
(214 cards)
Blood supply for most of the ear
Caudal auricular artery. Runs towards apex
Collection of blood within the cartilage plate of the ear. Usually accumulates in the concave surface of the ear.
Predisposing factors:
Otodectes-cats
Bacteria- dogs
Capillary fragility from Cushings disease
Aural Hematoma
Goals of aural hematoma correction
Remove blood or clot
Prevent reoccurrence
Retain ear appearance
When is non surgical correction of aural hematomas used
For recent and fluctuated hematomas, and smaller hematomas
When is surgical correction of aural hematomas recommended
Chronic hematomas, harder to remove clots through aspiration, larger hematomas
Non surgical management for aural hematomas
Usually done in first 24 hours.
Use 18g needle and drain. Combine aspiration with IV or local Dexamethasone or methylprednisolone infusion for better outcome.
In ears that stand up make hole closer to skull to allow for drainage, in flopped ears make hole near tip of pinna.
Should repeat procedure for better success rates
Surgical treatment for aural hematoma.
Uses Penrose drain (for 5 days) or Teat cannula (for 3-5 days)
Passive drainage
Surgical treatment for aural hematoma
Uses butterfly catheter secured into the end of the ear and suction can be applied when needed. Promotes adhesion
Active drainage
Surgical treatment for aural hematoma.
Incision types
S shaped gap: 2mm space heals by second intention
Dermal punch: use punch, place multiple mattress sutures to close
Laser: 1mm spaces made throughout pinna, allows for adhesions
When suturing the pinna, this is the most appropriate pattern used
Vertical mattress.
Runs same direction of blood supply to prevent occlusion accidentally.
Plate secured to ear for surgical treatment of aural hematoma. Used after drainage or aspiration of hematoma. Decreases dead space and creates adhesions. Usually left on for 2 weeks
Practice hematoma repair system
If laceration on one skin surface of the pinna…
Heals by second intention of suture. Pinna usually maintains normal position
If laceration of two skin surfaces or cartilage of pinna….
Must do primary closure (vertical mattress usually)
Deep bites used to align cartilage, and superficially bite aligns skin.
Locally invasive tumor. Caused bleeding and cracked non healing wounds on ear margins. Low metastatic rate.
Squamous cell carcinoma
Indication for subtotal or total pinnectomy
Neoplasia, trauma, SCC
Procedure specifics for subtotal or total pinnectomy
Take 1-2cm margins from lesions. Pull skin from convex over cartilage. Close with monofilament suture
Which bulla osteotomy is more common in dogs
Lateral
Which bulla osteotomy is more common in cats
Ventral
Primary causes of otitis externa
Parasites FB Hypersensitivities Keratinization disorders Autoimmune
Indication for lateral ear canal resection
Tumor involving tragus or lateral wall
Disease involving VERTICAL canal only
Improves ventilation, decreased moisture, better access for medicating
When performing a lateral ear canal resection why do you leave the ventral 1/3 of the flap created during surgery?
Decreases suture near stoma
Decreases strictures
Shifts hair bearing skin
Closure of a lateral ear canal resection
Suture epithelium and cartilage to skin, do deepest area first
Single layer closure using 3/0 monofilament
Complications with lateral ear canal resection
Inadequate drainage
Continued otitis externa (underlying disease or concurrent middle ear infection)
DONT DO THIS PROCEDURES IN COCKERS
Indications for a vertical ear canal resection
Hyperplastic otitis involving the vertical canal only.
Neoplasia
Trauma
Procedure is rarely done