Rigid endoscopy: otoendoscopy

image of Rigid endoscopy: otoendoscopy
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Ear disease is one of the most commonest conditions affecting dogs and cats. Otitis externa (OE) is one of the most common and challenging ear diseases encountered, particularly in the dog. In dogs chronic inflammation of the ear canal is frequently associated with an extension of inflammation to deeper structures of the ear, resulting in otitis media (OM) or, less commonly, otitis interna (OI). Feline OE is less prevalent and rarely progresses to OM. More commonly, feline OM is the consequence of aetiological factors that directly affect the middle ear (e.g. inflammatory polyps, neoplasia, infection from the upper respiratory tract). The first diagnostic procedure that must be performed on a patient with suspected ear disease is an otoscopic examination. This chapter examines Indications; Instrumentation; Patient preparation; Preoperative diagnostic work-up; Procedure; Normal findings; Pathological conditions; Postoperative care; and Complications.

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9.1 Veterinary otoscope set consisting of an otoscope for dogs and cats, and a stopcock attachment with integrated working channel. (Courtesy of Karl Storz GmbH & Co. KG, Tuttlingen, Germany)
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9.2 Vetpump2, a flushing and suction apparatus. (Courtesy of Karl Storz GmbH & Co. KG, Tuttlingen, Germany)
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9.3 Mild and hard waxy secretions in the ears of dogs with ceruminous OE.
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9.4 Purulent exudate in an ear of a dog with infection.
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9.5 Flushing technique using a VO system. Note the polypropylene catheter targeting tenacious debris. The same ear canal after several cycles of flushing and suctioning.
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9.6 Normal canine ear canal.
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9.7 Normal canine tympanic membrane. A = Pars flaccida; B = Pars tensa; C = Stria mallearis.
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9.8 Blood vessels in the pars tensa associated with the manubrium.
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9.9 Glandular proliferation of the horizontal ear canal of a dog with a history of chronic OE.
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9.10 Ulceration of the skin of the ear canal associated with infection.
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9.11 Mass of neoplastic origin discovered using video-otoscopy in the ear canal of a cat. Biopsy of the mass using biopsy forceps (visible at the top of the image) placed through the working channel on the video-otoscope. Histopathologically the mass was identified as ceruminal gland carcinoma.
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9.12 Inflammatory polyp in a cat. Note the pink to red smooth surface.
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9.13 A hard concretion at the eardrum of a dog.
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9.14 OM in a dog. Note the absence of the tympanic membrane.
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9.15 OM with rupture of the tympanic membrane.
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9.16 The bulged appearance of a tympanic membrane in a dog with empyema of the bulla.
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9.17 Proper position for performing a myringotomy, using an open-ended tomcat catheter. The incision is made in the caudoventral portion of the pars tensa (at 6 to 7 o’clock). C = Caudal; D = Dorsal; R = Rostral; V = Ventral.
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9.18 CT scan of left cholesteatoma in a male 8-year-old Afghan Hound. There is enlargement of the middle ear cavity, complete loss of air contrast and early mild lytic changes to the bulla wall. (Courtesy of M Di Giancamillo) Removal of a huge quantity of keratinic debris from the tympanic cavity of a 10-year-old male Flat-coated Retriever with right cholesteatoma during a total ear canal ablation procedure. (Courtesy of CM Mortellaro)
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