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Surgery of the ear
British Small Animal Veterinary Association , 61 (2018); https://doi.org/10.22233/9781910443347.5
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Surgery of the ear

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Abstract

This chapter covers anatomy, surgery of the pinna, otitis externa and media, otic and nasopharyngeal polyps, middle ear cholesteatomas in dogs and considerations for surgical success in patients with ear disease. : Lateral ear canal resection; Vertical ear canal resection; Total ear canal ablation and lateral bulla osteotomy.

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Figures

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5.1
Anatomy of the canine external ear. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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5.1 Anatomy of the canine external ear. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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5.2
Anatomy of the canine bulla. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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5.2 Anatomy of the canine bulla. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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5.3
Auricular haematoma treated with oral steroids and a continuous suction drain made from a fenestrated butterfly catheter and vacuum tube. After the drain was placed, the dog’s ear was affixed to its head with tape and a bandage to prevent head shaking. © 2018 British Small Animal Veterinary Association
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5.3 Auricular haematoma treated with oral steroids and a continuous suction drain made from a fenestrated butterfly catheter and vacuum tube. After the drain was placed, the dog’s ear was affixed to its head with tape and a bandage to prevent head shaking.
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5.4
Otoscopic examination. (a) Normal tympanic membrane. (b) Ruptured membrane. As is often the case, the diseased tympanum is tearing away from its rostral attachment to the manubrium. This may be interpreted as an intact tympanum if the otoscopic visual field is obscured or the light source is poor. © 2018 British Small Animal Veterinary Association
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5.4 Otoscopic examination. (a) Normal tympanic membrane. (b) Ruptured membrane. As is often the case, the diseased tympanum is tearing away from its rostral attachment to the manubrium. This may be interpreted as an intact tympanum if the otoscopic visual field is obscured or the light source is poor.
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5.5
End-stage otitis in a Cocker Spaniel/Miniature Poodle crossbreed that had undergone lateral wall resection, with complete blockade of the ear canal opening. The obstructive tissue was a combination of hyperplastic glandular tissue with associated osseous metaplasia. © 2018 British Small Animal Veterinary Association
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5.5 End-stage otitis in a Cocker Spaniel/Miniature Poodle crossbreed that had undergone lateral wall resection, with complete blockade of the ear canal opening. The obstructive tissue was a combination of hyperplastic glandular tissue with associated osseous metaplasia.
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5.6
Radiographic appearance of otitis media in a dog. In this open-mouth view of the skull, soft tissue density fills the left bulla (arrowed). © 2018 British Small Animal Veterinary Association
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5.6 Radiographic appearance of otitis media in a dog. In this open-mouth view of the skull, soft tissue density fills the left bulla (arrowed).
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5.7
Aural, or otic, polyp extending through the tympanic membrane into the horizontal canal of a cat. © 2018 British Small Animal Veterinary Association
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5.7 Aural, or otic, polyp extending through the tympanic membrane into the horizontal canal of a cat.
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5.8
Horner’s syndrome in a cat after ventral bulla osteotomy. © 2018 British Small Animal Veterinary Association
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5.8 Horner’s syndrome in a cat after ventral bulla osteotomy.
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The patient is in lateral recumbency with the pinna lying over the head, away from the surgical site.
The patient is in lateral recumbency with the pinna lying over the head, away from the surgical site. © 2018 British Small Animal Veterinary Association
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Image of The patient is in lateral recumbency with the pinna lying over the head, away from the surgical site.
The patient is in lateral recumbency with the pinna lying over the head, away from the surgical site. The patient is in lateral recumbency with the pinna lying over the head, away from the surgical site.
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An instrument is inserted into the ear canal to identify the position of the vertical canal. A U-shaped incision is made over the lateral surface of the canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
An instrument is inserted into the ear canal to identify the position of the vertical canal. A U-shaped incision is made over the lateral surface of the canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of An instrument is inserted into the ear canal to identify the position of the vertical canal. A U-shaped incision is made over the lateral surface of the canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
An instrument is inserted into the ear canal to identify the position of the vertical canal. A U-shaped incision is made over the lateral surface of the canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. An instrument is inserted into the ear canal to identify the position of the vertical canal. A U-shaped incision is made over the lateral surface of the canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Subcutaneous tissues are dissected away from the lateral surface of the vertical canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Subcutaneous tissues are dissected away from the lateral surface of the vertical canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of Subcutaneous tissues are dissected away from the lateral surface of the vertical canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Subcutaneous tissues are dissected away from the lateral surface of the vertical canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. Subcutaneous tissues are dissected away from the lateral surface of the vertical canal. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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To ensure the cuts in the vertical ear canal are in the correct site, it is helpful to score the cartilage with a scalpel tip. These marks can then be followed with the scissors (see next image). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
To ensure the cuts in the vertical ear canal are in the correct site, it is helpful to score the cartilage with a scalpel tip. These marks can then be followed with the scissors (see next image). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of To ensure the cuts in the vertical ear canal are in the correct site, it is helpful to score the cartilage with a scalpel tip. These marks can then be followed with the scissors (see next image). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
To ensure the cuts in the vertical ear canal are in the correct site, it is helpful to score the cartilage with a scalpel tip. These marks can then be followed with the scissors (see next image). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. To ensure the cuts in the vertical ear canal are in the correct site, it is helpful to score the cartilage with a scalpel tip. These marks can then be followed with the scissors (see next image). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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The lateral wall of the vertical canal is incised to form the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The lateral wall of the vertical canal is incised to form the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of The lateral wall of the vertical canal is incised to form the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The lateral wall of the vertical canal is incised to form the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. The lateral wall of the vertical canal is incised to form the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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The distal third of the cartilage flap is transected to complete the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The distal third of the cartilage flap is transected to complete the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of The distal third of the cartilage flap is transected to complete the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The distal third of the cartilage flap is transected to complete the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. The distal third of the cartilage flap is transected to complete the ‘drainage board’. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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The superficial skin of the flap is sutured to the ventral margins of the skin incision. The horizontal canal opening should be checked before closure continues. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The superficial skin of the flap is sutured to the ventral margins of the skin incision. The horizontal canal opening should be checked before closure continues. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of The superficial skin of the flap is sutured to the ventral margins of the skin incision. The horizontal canal opening should be checked before closure continues. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
The superficial skin of the flap is sutured to the ventral margins of the skin incision. The horizontal canal opening should be checked before closure continues. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. The superficial skin of the flap is sutured to the ventral margins of the skin incision. The horizontal canal opening should be checked before closure continues. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Closure is completed with figure-of-eight or simple interrupted skin sutures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Closure is completed with figure-of-eight or simple interrupted skin sutures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2018 British Small Animal Veterinary Association
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Image of Closure is completed with figure-of-eight or simple interrupted skin sutures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Closure is completed with figure-of-eight or simple interrupted skin sutures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. Closure is completed with figure-of-eight or simple interrupted skin sutures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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The skin and auricular cartilage are cut circumferentially around the external opening of the vertical canal.
The skin and auricular cartilage are cut circumferentially around the external opening of the vertical canal. © 2018 British Small Animal Veterinary Association
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Image of The skin and auricular cartilage are cut circumferentially around the external opening of the vertical canal.
The skin and auricular cartilage are cut circumferentially around the external opening of the vertical canal. The skin and auricular cartilage are cut circumferentially around the external opening of the vertical canal.
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The vertical canal is dissected free of soft tissue attachments.
The vertical canal is dissected free of soft tissue attachments. © 2018 British Small Animal Veterinary Association
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Image of The vertical canal is dissected free of soft tissue attachments.
The vertical canal is dissected free of soft tissue attachments. The vertical canal is dissected free of soft tissue attachments.
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The vertical canal is transected, leaving a small amount of auricular cartilage.
The vertical canal is transected, leaving a small amount of auricular cartilage. © 2018 British Small Animal Veterinary Association
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Image of The vertical canal is transected, leaving a small amount of auricular cartilage.
The vertical canal is transected, leaving a small amount of auricular cartilage. The vertical canal is transected, leaving a small amount of auricular cartilage.
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The auricular cartilage is transected midway along its rostral and caudal circumferences to make two cartilage flaps.
The auricular cartilage is transected midway along its rostral and caudal circumferences to make two cartilage flaps. © 2018 British Small Animal Veterinary Association
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Image of The auricular cartilage is transected midway along its rostral and caudal circumferences to make two cartilage flaps.
The auricular cartilage is transected midway along its rostral and caudal circumferences to make two cartilage flaps. The auricular cartilage is transected midway along its rostral and caudal circumferences to make two cartilage flaps.
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The skin is advanced rostrally to determine its final position.
The skin is advanced rostrally to determine its final position. © 2018 British Small Animal Veterinary Association
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Image of The skin is advanced rostrally to determine its final position.
The skin is advanced rostrally to determine its final position. The skin is advanced rostrally to determine its final position.
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The advanced skin flap is held in place with a simple interrupted suture, and then the epithelium covering the cartilage flaps is sutured to the adjacent skin.
The advanced skin flap is held in place with a simple interrupted suture, and then the epithelium covering the cartilage flaps is sutured to the adjacent skin. © 2018 British Small Animal Veterinary Association
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Image of The advanced skin flap is held in place with a simple interrupted suture, and then the epithelium covering the cartilage flaps is sutured to the adjacent skin.
The advanced skin flap is held in place with a simple interrupted suture, and then the epithelium covering the cartilage flaps is sutured to the adjacent skin. The advanced skin flap is held in place with a simple interrupted suture, and then the epithelium covering the cartilage flaps is sutured to the adjacent skin.
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Final appearance of a vertical ear canal ablation in a dog with congenital stenosis of the vertical ear canal.
Final appearance of a vertical ear canal ablation in a dog with congenital stenosis of the vertical ear canal. © 2018 British Small Animal Veterinary Association
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Image of Final appearance of a vertical ear canal ablation in a dog with congenital stenosis of the vertical ear canal.
Final appearance of a vertical ear canal ablation in a dog with congenital stenosis of the vertical ear canal. Final appearance of a vertical ear canal ablation in a dog with congenital stenosis of the vertical ear canal.
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The pinna and lateral facial skin have been clipped and prepared. The ear is hung froma sterile towel clamp whilst drapes are placed.
The pinna and lateral facial skin have been clipped and prepared. The ear is hung froma sterile towel clamp whilst drapes are placed. © 2018 British Small Animal Veterinary Association
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Image of The pinna and lateral facial skin have been clipped and prepared. The ear is hung froma sterile towel clamp whilst drapes are placed.
The pinna and lateral facial skin have been clipped and prepared. The ear is hung froma sterile towel clamp whilst drapes are placed. The pinna and lateral facial skin have been clipped and prepared. The ear is hung froma sterile towel clamp whilst drapes are placed.
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After the skin has been incised, the auricular cartilage is transected circumferentially around the vertical canal opening with curved Mayo or cartilage scissors.
After the skin has been incised, the auricular cartilage is transected circumferentially around the vertical canal opening with curved Mayo or cartilage scissors. © 2018 British Small Animal Veterinary Association
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Image of After the skin has been incised, the auricular cartilage is transected circumferentially around the vertical canal opening with curved Mayo or cartilage scissors.
After the skin has been incised, the auricular cartilage is transected circumferentially around the vertical canal opening with curved Mayo or cartilage scissors. After the skin has been incised, the auricular cartilage is transected circumferentially around the vertical canal opening with curved Mayo or cartilage scissors.
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The soft tissues are carefully dissected away from the auricular cartilage.
The soft tissues are carefully dissected away from the auricular cartilage. © 2018 British Small Animal Veterinary Association
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Image of The soft tissues are carefully dissected away from the auricular cartilage.
The soft tissues are carefully dissected away from the auricular cartilage. The soft tissues are carefully dissected away from the auricular cartilage.
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The facial nerve is visible along the ventrolateral surface of the annular cartilage.
The facial nerve is visible along the ventrolateral surface of the annular cartilage. © 2018 British Small Animal Veterinary Association
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Image of The facial nerve is visible along the ventrolateral surface of the annular cartilage.
The facial nerve is visible along the ventrolateral surface of the annular cartilage. The facial nerve is visible along the ventrolateral surface of the annular cartilage.
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Ring retractors improve exposure during soft tissue dissection around the annular cartilage.
Ring retractors improve exposure during soft tissue dissection around the annular cartilage. © 2018 British Small Animal Veterinary Association
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Image of Ring retractors improve exposure during soft tissue dissection around the annular cartilage.
Ring retractors improve exposure during soft tissue dissection around the annular cartilage. Ring retractors improve exposure during soft tissue dissection around the annular cartilage.
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The bulla has been opened to expose debris and thickened lining, which will be removed with curettes, forceps or lavage.
The bulla has been opened to expose debris and thickened lining, which will be removed with curettes, forceps or lavage. © 2018 British Small Animal Veterinary Association
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Image of The bulla has been opened to expose debris and thickened lining, which will be removed with curettes, forceps or lavage.
The bulla has been opened to expose debris and thickened lining, which will be removed with curettes, forceps or lavage. The bulla has been opened to expose debris and thickened lining, which will be removed with curettes, forceps or lavage.
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