Soft Tissue Surgery: Ear Surgery

Question 1

How is laceration of the pinna treated with:
1. One skin layer affected
2. Skin and cartilage affected

Answer 1

1. Clean, debride and suture- second intention if small
2. Suture with vertical matress in dogs, second skin with simple if required, start at ear margin

Cats- concave surface first

Question 2

What can cause an aural haematoma?

How is it medically and surgically treated?

Answer 2

Haematome in the pinna due to truama, head shaking, scratcing- can fibrose

Medically
* Needle drainage and methylpred injection

Surgical
* Acute- stab, lavage, drain
* Chronic- surgical drainage- suturing of pinna

Question 3

How is a pinnectomy performed?

Answer 3

• Incisde pinna with scalpel or scissors- 1-2cms from lesion
• Cautery for haemostasis
• Pull skin of convex surface over cut edge and suture to skin of concave surface

Question 4

What are indications for surgical treatment of otitis externa?

Answer 4

• Failure of medical treatment
• Irreversible change in ear canal
• Cutaneous fistula
• Para-aural abscess
• Otitis media or interna

Question 5

What are the indications for lateral wall resection?

Answer 5

• Improving ventilation of ear canal
• Reduce humidity
• Small tumours

Question 6

What are the indications of vertical canal ablation

Answer 6

Treatment of severe disease when horizontal is not affected

Question 7

When is total ear canal ablation indicated?

Answer 7

• Ceruminous gland adenocarcinoma
• Extensive irreversible hyperplastic otitis
• Presence of otitis media/interna
• Failed lateral wall resection

Question 8

What are complications of lateral wall resection and vertical canal ablation?

Answer 8

• Dehisence
• Stricture
• Self-trauma

Question 9

What are complications of TECA?

Answer 9

• Horners
• Facial paralysis
• Haemorrhage
• Infection/dihiscence
• Para-aural abscess
• Reduced hearing

Question 10

What are the signs of septic otitis media?

Answer 10

Dogs
Pain, altered head carriage, jaw pain, purulent discharge
Neurological signs
* facial paralysis
* Horners
* Peripheral vestibular disease

Bulging, loss of translucency, changed colour, perforation of tympanic membrane

Radiography/MRI
Myringotomy if tympanic membrane intact

Question 11

How are inflammatory polyps treated?

Answer 11

Remove by traction
Oral prednisolone
Surgery- TECA, ventrall bullae osteotomy

Question 12

What are complicatoins of ventral bullae osteotomy?

Answer 12

• Horners syndrome
• Facial paralysis
• Peripheral vestibular disease
• Haemorrhage from lingual artery
• Damage to hypoglossal nerve