What is an auricular hematoma?
rupture of the blood vessels within the cartilage of the ear flap causing accumulation of blood
What is the number one cause of an auricular hematoma?
otitis externa
When is non-surgical therapy preferred for auricular hematoma?
- recent and fluctant hematomas
- smaller hematomas
- easy to drain
How is an auricular hematoma treated non-surgically?
- aspiration alone
- with IV dexamethasone
- with local dex infusion
- with local methyl prednisolone
How can auricular hematomas be treated surgically?
- penrose drain
- larson teat cannula
- butterfly catheter drain
- incisional drainage
Describe the Penrose drain
- passive drain
- fluid drains around the drain
- entrance and exit holes
- leave in for 7-10 days
- encourages inflammation and therefore adhesions
Describe the Larson teat cannula
- passive drain
- fenestrated cannula
- make incision into hematoma, drain, place cannula, and suture in place
- promotes drainage and formation of adhesions
Describe the butterfly catheter drain
- active drain
- cut off end of catheter
- fenestrate the area that will be inserted in the hematoma
- make a defect in the hematoma, drain, and insert catheter
- secure catheter, and place other end in a vacutainer
How is a pinna laceration that is one skin surface deep, treated?
2nd intention or suture
How is a pinna laceration that is two skin surfaces/cartilage deep, treated?
- primary closure
- vertical mattress sutures
How is a laceration of the ear tip treated?
superficial partial pinnectomy
How is a squamous cell carcinoma of the ear treated?
pinnectomy +/- vertical ear canal ablation
What are the primary causes of otitis externa?
- parasites
- foreign body
- hypersensitivities
- keratinization disorders
- autoimmune
What are predisposing factors to otitis externa?
- pendulous ears
- narrow canals
- excessive hair
- excessive cerumen
- chronic ear moisture
- inappropriate antibiotics
- polyps or tumors
Which surgical procedures are used for otitis externa?
- lateral ear canal resection
- vertical ear canal resection
- total ear canal ablation with lateral bulla osteotomy
What are the indications for a lateral ear canal resection?
- when a tumor involves the tragus or lateral wall of the vertical canal
Describe the lateral ear canal resection procedure
- make two parallel incisions along the ear canal
- bluntly dissect around the lateral portion of the canal
- create a skin flap, attached to the tragus
- remove lateral section of ear canal
- remove proximal 2/3 of flap
- suture epithelium and cartilage to skin
Which procedure is contraindicated in Cocker Spaniels?
lateral ear canal resection
What are the indications for a vertical ear canal resection?
- hyperplastic otitis involving vertical canal only
- neoplasia involving vertical canal only
- trauma
Describe the vertical ear canal resection procedure
- removal of entire vertical canal
- T-shaped incision down middle or ear canal and level of tragus
What are the indications for a total ear canal ablation with lateral bulla osteotomy?
- ceruminous gland adenocarcinoma
- extensiv benign otitis
- failed lateral ear canal resection
- middle ear disease
Which is the best diagnostic procedure for detecting middle ear disease?
MRI
When is surgical management indicated for middle ear disease?
- severe canal stenosis
- tympanic bulla infection
- failure of medical management
- significant neurological signs
What surgical procedures are used to treat middle ear disease?
- total ear canal ablation
- bulla osteotomy
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