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Surgical management of otitis media and otitis interna.

Surgical management of otitis media and otitis interna includes the following options: lateral bulla osteotomy, ventral bulla osteotomy, or curettage of the tympanic cavity. Because otitis media frequently accompanies chronic nonresponsive otitis externa, one of the above procedures may be combined with operative procedures of the external ear canal. Also, gentle selective curettage of the tympanic cavity may be combined with either lateral or ventral bulla osteotomy in the treatment of otitis media and interna. The choice of surgical procedure(s) should be based on the condition of the external ear canal (vertical and horizontal parts), the duration of clinical signs, response to previous surgery, and the familiarity of the surgeon with the different approaches and techniques. With the increased reporting of long-term results following surgical management of otitis externa, media, and interna, more meaningful conclusions concerning selection of surgical procedure may be made in the future.

Animals↗

Otitis interna is a frequent sequela to Streptococcus suis meningitis in pigs.

Twenty-eight histologically confirmed cases of porcine leptomeningitis were examined retrospectively, with focus on the pathology of the inner and middle ear, brain, and vestibulocochlear nerve. Tissues were evaluated by histology and immunohistochemistry for Streptococcus suis serotype 2 antigen, and the bacteriologic results were recorded. Exudative otitis interna was diagnosed in 20/28 pigs (71%). The lesions primarily affected the perilymphatic ducts, with consistent involvement of the scala tympani. Perineuritis of the vestibulocochlear nerve was seen in all but four of the ears affected with otitis interna. Immunohistochemically, S. suis serotype 2 antigen was demonstrated in the leptomeningeal, perineural, and labyrinthine exudates in 11 cases. Otitis media was diagnosed in 10/28 pigs (34%), but evidence of extension to the inner ear was not observed. The findings were highly similar to descriptions of meningogenic labyrinthitis in humans and in laboratory animal models. Otitis interna in pigs can also develop via the meningogenic route and is not always, as generally stated, tympanogenic.

Animals↗

Otitis interna as a result of Pasteurella multocida infection in a laboratory woodchuck.

A laboratory woodchuck presented clinically with left-sided torticollis and a purulent exudate within the external auditory meatus of the left ear. Bacterial culture of the exudate resulted in a heavy growth of Pasteurella multocida. Treatment was initiated with topical and systemic antimicrobial compounds. There was no clinical improvement after 72 h of treatment, and euthanasia was elected. Radiographs correlated well with necropsy findings, confirming a diagnosis of otitis media; otitis interna was not confirmed but was suggested by the clinical presentation. To the authors knowledge, this is the first description of otitis media/interna as a result of P. multocida infection in a laboratory woodchuck.

Animals↗

Panophthalmitis and otitis interna in fire-bellied toads.

Microbiologic and histologic studies were made of fire-bellied toads with signs of ocular and central nervous system disease. Providencia alcalifaciens, Citrobacter freundii, Aeromonas hydrophila, and other gram-negative bacilli were isolated from the eyes and multiple tissues of ill toads. The histologic evaluations revealed severe panophthalmitis and otitis interna.

Animals↗

A pathologic and bacteriologic study on otitis media in swine.

A pathologic and bacteriologic study on otitis media in swine was performed on 237 swine, ranging in age from 1 day to 1 year. These 237 swine from eight selected farms were slaughtered due to unfavorable prognosis associated with clinical signs of illness. One hundred sixty-three (68.8%) of the 237 swine were found to be affected with otitis, though only a few swine showed clinical signs characteristic of the disease. One hundred fifty-one (63.7%), 53 (22.4%), and 39 (16.5%) had lesions in the middle, external, and internal ear, respectively. Of the 151 cases with otitis media, bilateral and unilateral infection accounted for 114 (75.5%) and 37 (24.5%), respectively. Only 5/53 swine with otitis externa and 6/39 swine with otitis interna failed to show otitis media. All swine with infection in the tympanic cavity had inflammatory lesions in the auditory tube. Examination of the swine grouped by age revealed that, regardless of age, incidence of otitis media was 50-70%. In swine younger than 1 month old, otitis media tended to center on the auditory tube, where a mild infiltration of neutrophils into the mucous membrane was frequent. Thereafter, otitis media increased in degree and extent with age. Forty (26.5%) of the 151 swine affected with otitis media were accompanied by a substantial amount of inflammatory exudate in the tympanic cavity and bulla. Purulent exudate was found in 20/40 (50%) swine. Severe otitis media prevailed in swine between 1 and 4 months of age, showing inspissation of a suppurative exudate in the tympanic cavity and lysis of the underlying osseous wall of the tympanic bulla with subsequent fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Actinomyces↗

Otitis media and interna and temporohyoid osteoarthropathy.

Otitis media/interna in the equine most commonly is a chronic, insidious infection with the unique sequella of temporohyoid osteoarthropathy in some horses. Head shaking may be the only clinical sign of the early stages of this disease. The arthritic condition often leads to fusion of the temporohyoid joint with resultant stress fractures of the petrous temporal bone. When this occurs, the horse presents as an acute neurologic case with clinical signs of vestibular and facial nerve dysfunction. Diagnosis, treatment, and prognosis are discussed. Recognition of this syndrome is important because many of these horses can be treated successfully and can return to normal function.

Animals↗

Total ear canal ablation combining bulla osteotomy and curettage in dogs with chronic otitis externa and media.

Ear canal ablation combining bulla osteotomy and curettage was performed on 44 dogs (n = 72 ears). Indications for the procedure included one or more of the following: chronic nonresponsive otitis externa and/or media (n = 71), tumor in the horizontal portion of the ear canal (n = 1), failed lateral ear resection (n = 11), ossified auricular cartilages secondary to chronic otitis externa (n = 22), failed previous total ear canal ablation (n = 1), and otitis interna (n = 1). In 40 dogs, the surgery was successful in alleviating all clinical signs of otitis externa and media. During the immediate postoperative period, 2 dogs died of causes unrelated to otitis. Complications related to the surgery developed in 9 of the surviving 42 dogs. Ultimately, 95% (40 of the surviving 42) of the dogs were cured by use of this procedure. Surgery successfully resolved the original problems in 97% (66 of 68) of the surgically treated ears of these dogs.

Animals↗

Acute meningoencephalomyelitis in a rabbit infected with Pasteurella multocida.

Pasteurella multocida was isolated in pure culture from the optic chiasm of a rabbit that was euthanatized subsequent to acute development of neurological signs. Histopathologically, there was meningoencephalomyelitis, bilateral otitis interna, retrobulbar cellulitis, optic neuritis and iritis. The ocular involvement, severity of the spinal lesions and the lack of otitis media was unusual.

Acute Disease↗

Tympanic bulla osteotomy for treatment of middle-ear disease in cats: 19 cases (1984-1991).

Twenty-two tympanic bulla osteotomies were performed in 19 cats for the treatment of bacterial otitis media (n = 11), inflammatory polyps (n = 7), or middle-ear neoplasia (n = 4). Inflammatory polyps mostly affected young adult cats (mean age, 1.5 years), whereas otitis media affected middle-aged cats (mean age, 5.5 years) and neoplasia affected older cats (mean age, 10.25 years). Although not specific for the underlying disease process, fluid density within the tympanic bulla or thickening of the bulla was observed radiographically in 100% of cats with middle-ear disease. In cats for which results were available, bacterial culturing revealed pathogens in 6 cats diagnosed with otitis media and in 7 cats with benign or malignant tumors within the bulla. The ventral approach to the bulla was the most common surgical procedure (18 osteotomies), followed by the lateral approach combined with ablation of the vertical and horizontal parts of the external acoustic meatus (4 osteotomies). Immediate postoperative complications were common but short-term, and included Horner's syndrome (11 cats), facial nerve paralysis (5 cats), and otitis interna (2 cats). Bulla osteotomy resulted in resolution of clinical signs without recurrence in cats with middle-ear polyps. Drainage of the infected tympanic cavity aided in resolution of the clinical signs of bacterial otitis media, but the long-term clinical course was characterized by persistent neurologic deficits (5 cats) and recurrence of disease (2 cats). Neoplastic infiltration of the tympanic bulla was associated with a poor prognosis, and although surgery helped to establish a diagnosis, it did not alter the clinical course of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Nasopharyngeal polyps in cats.

Nasopharyngeal polyps are non-neoplastic, inflammatory growths that arise from the middle ear or the eustachian tube and extend into the pharynx. The exact etiology of nasopharyngeal polyps is unclear; proposed etiologies include a response to chronic upper respiratory tract infection, chronic otitis media, ascending infection from the nasopharynx, or a congenital origin. Clinical signs usually relate to obstruction of the nasopharynx, with Horner's syndrome and head tilt being consistent with otitis media and otitis interna, respectively. Diagnostic tools include digital or visual examination above the soft palate, flexible fiberoptic caudal rhinoscopy, radiography, computed tomography, and magnetic resonance imaging. Ventral bulla osteotomy combined with traction removal of the polyp is the recommended treatment, although traction only followed by prednisolone therapy can be considered in some cases, especially when there is no evidence of otitis media.

Animals↗

[Investigations on clinical diagnosis and pathogenesis of otitis media et interna in swine].

A total of 25 pigs with a head tilt as clinical sign of otitis media et interna were examined. The majority were weaner-pigs with respiratory tract disorders. In lateral and ventrodorsal radiographic views of the bulla tympanica, there was an increased opacity, often accompanied by marginal destruction or thickening of the bulla wall. The findings confirmed the clinical diagnosis in each affected pig. In the case of leptomeningitis an examination of the cerebrospinal fluid revealed a drastic increase in the cell count. In 20 of 23 microbiologically examined empyemic bullae a polyinfection was seen. The results indicate that the route of infection of the middle ear is by the auditory tube. Mange on the other hand plays only a minor role in the pathogenesis of otitis media.

Animals↗