Term
| The tympanic membrane separates the ___ ear from the ___ ear. |
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Definition
| separates external ear from middle ear |
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Term
| The tympanic bulla is part of the ___ ear. |
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Definition
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Term
| The ossicles are part of the ___ ear. |
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Definition
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Term
| The cochlea is part of the ___ ear. |
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Definition
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Term
| What part of the ear is responsible for balance? |
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Definition
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Term
| What part of the ear may resemble eye sockets when viewed on a radiograph? |
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Definition
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Term
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Definition
| -blood clot in the ear pinna that separates the two skin and cartilage layers |
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Term
| Can aural hematomas heal on their own? |
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Definition
| Yes, over weeks and months, but there will be permanent cartilage shape changes, and considerable pain. |
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Term
| Why do we encourage surgical treatment of aural hematomas? |
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Definition
-considerable throbbing pain
-avoid permanent cartilage shape changes
-treat underlying cause |
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Term
| Who is most prone to ear hematomas? |
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Definition
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Term
| How do aural hematomas form? |
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Definition
| broken blood vessels from trauma - flapping, scratching, batting |
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Term
| 3 common causes of aural hematomas: |
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Definition
-ear mites, esp. in cats
-otitis externa, esp. in floppy-eared dogs
-allergies- atopy from inhaled allergens |
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Term
| Why would allergies lead to aural hematoma? |
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Definition
-atopy is an allergic reaction to inhaled allergens
-dogs/cats store histamines in their ears, paws |
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Term
| Ways to Tx aural hematomas: |
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Definition
-treat underlying cause (ear mite meds, Abx, anti-itch, hypoallergenic diet, etc)
-tap hematoma but < 50% effective
-surgically incise = only true cure |
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Term
| When might tapping an aural hematoma with a needle be sufficient Tx? |
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Definition
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Term
| What is the efficacy of treating an aural hematoma by tapping with a hypodermic needle? |
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Definition
| < 50% because you must remove clot, fibrin, etc to prevent recurrence; also doesn't remove dead space |
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Term
| Laser vs Scalpel Tx of aural hematoma |
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Definition
laser: make several holes in swollen part
scalpel: make long incision along swollen part |
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Term
| After incising the aural hematoma, what is must be done? |
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Definition
-drain
-flush
-remove all fibrin clots |
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Term
| After treating an aural hematoma, what do ear wraps prevent? |
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Definition
-flapping of ears, spraying of blood
-scratching and rubbing of ear |
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Term
| If an aural hematoma is tapped, what might the vet do to encourage the hole to stay open and drain? Is this very effective? |
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Definition
-tape or suture a catheter in place (feeding cath, tomcat cath), or teat cannula
-can fly out with ear flapping |
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Term
| Notes on prepping an ear for aural hematoma Sx: |
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Definition
-very tedious
-clip all hair without nicking skin
-caudal edge of ear has pouch naturally
-tiny grooves on ear hard to shave |
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Term
| For aural hematoma Sx, the pinna is incised on the ____ surface. |
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Definition
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Term
| Styles of suturing around the incision from an aural hematoma Sx? |
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Definition
-simple interrupted all over around incision
-like a purse-string suture around incision |
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Term
| The sutures in the pinna after an aural hematoma Sx will act as ___ ___ to hold the layers of cartilage together. |
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Definition
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Term
| What sort of suture material is used to correct aural hematoma? |
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Definition
| large gauge suture, like 1-2ga |
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Term
| T/F: After aural hematoma Sx, sutures should be placed with significant tension. |
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Definition
| FALSE- tension doesn't matter, and may actually make the animal inflict more self-trauma |
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Term
| What is "PractiVet Hematoma System"? What other material may vets use in a similar manner? |
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Definition
-product to use with aural hematoma Sx
-plastic placed over ear before suturing
-some people use x-ray film in this manner, or buttons
-Dr. Keller thinks its not really necessary, but adds expense |
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Term
| Important points of hematoma Sx: |
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Definition
-leave incision open, gaping
-allow drainage; remove scabs for first week
-many suture, each is welding point
-suture tension not a factor
-leave sutures in for 3 weeks, but check after 10d for infection, healing abnormalities
-post-op drainage is messy! |
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Term
| A dog that gets ear hematomas in November may have... |
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Definition
| dust mite allergy! (people turn on heat, dust mites spew forth from air vents) |
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Term
| Why might a vet recommend boarding an aural hematoma patient for the first 3-4d after Sx? |
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Definition
-incision is left open and can be very messy
-must remove scabs to allow drainage
-cleaning and bandage changes = more mess |
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Term
| T/F: Dogs that undergo aural hematoma Sx often develop hematomas in the same spot in the future. |
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Definition
| FALSE- cartilage heals stronger than before from all the "welding points" of suture |
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Term
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Definition
-lateral wall resection
-total ear ablation
-bulla osteotomy |
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Term
| When is ear canal Sx needed? |
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Definition
-when ear canals are cauliflowered (swollen, stenotic) and permanently shut; "cocker ear"
-tumors in ear canal |
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Term
| Chronic otitis externa leads to a closed off ear canal known as "______": |
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Definition
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Term
| What is the purpose of lateral ear resection? |
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Definition
| -increase drainage and improve air flow in the ear |
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Term
| Essentially, lateral ear resection makes the ear canal like... |
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Definition
| a human ear canal (just horizontal canal) |
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Term
| Lateral ear resection is recommended for: |
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Definition
-animals with chronic otitis externa but before severe cartilage changes occur
-or if tumors block vertical ear canal |
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Term
| When is total ear canal ablation performed? |
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Definition
-when medical management has failed
-cartilage at this stage is often calcified |
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Term
| A bulla osteotomy is often performed in conjunction with what Sx? Why? |
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Definition
| total ear canal ablation, because of otitis media and/or otitis interna |
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Term
| What happens when an ear canal becomes totally swollen shut? |
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Definition
-wax, year, bacteria have no way out
-ruptures tympanic membrane
-infection in middle ear / bulla |
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Term
| The owners of a patient undergoing total ear canal ablation should be warned about what? |
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Definition
Facial nerve (CNVII) damage post-op:
-loss of blinking, dries up tears
-drooping facial muscles, drooling, food stuck in lip |
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Term
| Why would facial nerve damage occur during total ear canal ablation? |
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Definition
| CNVII located at base of ear; can nick with scalpel or it can be compressed by swollen tissues |
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Term
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Definition
| creating a hole in the bulla to allow for drainage |
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Term
| Total ear canal ablation involves the removal of what structures? |
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Definition
| vertical and horizontal ear canal, and ventral bulla |
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Term
| Can an animal still hear after a total ear canal ablation? |
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Definition
-cochlea still intact, so yes
-might be muffled, but animal probably wasn't hearing any better before Sx because canal was swollen shut |
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Term
| Notes on total ablation post-op: |
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Definition
-eye drops? until blink reflex returns
-pain management: multi-modal analgesia
-frequent cleaning, and/or bandage changes to prevent serum scalding, self trauma, mess
-manage facial nerve injury cases (clean food from lips, wipe drool) |
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