Middle ear polyps: results of traction avulsion after a lateral approach to the ear canal in 62 cats (2004–2014)

Abstract

Objectives The objective of this study was to report the surgical outcome and complication rate of deep traction avulsion (TA) of feline aural inflammatory polyps after a lateral approach (LA) to the ear canal. Methods This was a retrospective analysis of data retrieved from an electronic database of 62 cats treated with TA after an LA (TALA) for removal of ear canal polyps. Long-term outcome was assessed via a telephone questionnaire survey with the owners. Results Domestic shorthair cats (48%) and Maine Coons (37%) were over-represented. The most common presenting clinical signs were otorrhoea, ear scratching and head shaking. Video-otoscopic examination confirmed a polypous mass in the ear canal in all patients. All 62 cats underwent TALA, with a mean surgical time of 33 mins for experienced surgeons (n = 4) and 48 mins (n = 12) for less experienced surgeons. The recurrence rate of polyp regrowth for experienced surgeons was 14.3% vs 35% for the less experienced surgeons. Postoperative complications included Horner's syndrome (11.5%) and facial nerve paralysis (3%). Otitis interna was not observed. Conclusions and relevance A lateral approach to the ear canal in combination with deep TA of an aural inflammatory polyp is an effective first-line technique that results in a low recurrence and complication rate.

Feline bilateral inflammatory aural polyps: a descriptive retrospective study

“…More cats had recurrence of aural IP with simple traction (traction performed without curettage of the tympanic cavity) removal versus surgical intervention, a finding consistent with comparisons from previous reports. [19][20][21][22][23] For those cats where recurrence was documented, use of topical and/or systemic glucocorticoids did not seem to have an impact on time to recurrence. A larger sample size may have yielded different results, as several authors 23 have suggested a relationship between glucocorticoid therapy and lack of recurrence of polyps.…”

Clinical reasoning in feline vestibular syndrome: which presenting features are the most important?

“…2 This association is further supported by frequent reports of Horner syndrome occurring postoperatively following polyp removal using traction avulsion or ventral bulla osteotomy. 55–57…”

Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors

“…66 In addition to signs of otitis externa, affected patients may have vestibular signs, respiratory signs, ocular discharge or blepharo spasm, or Horner's syndrome. 66,68 IAPs occur most commonly in young cats and kittens, though they can develop at any age. 66,68,69 If visible on otoscopy, IAPs often appear as a smooth, pink nodule in the canal at the level of the tympanum (Figure 4).…”

“…65 IAPs are usually treated in one of two ways: traction avulsion or ventral bulla osteotomy (VBO). 66,68 At the time of the procedure, cats should be evaluated for concurrent nasopharyngeal polyp. 65 Complications may occur with either of these treatment approaches, including Horner's syndrome, vestibular signs, hemorrhage and facial nerve paralysis.…”

“…65 Complications may occur with either of these treatment approaches, including Horner's syndrome, vestibular signs, hemorrhage and facial nerve paralysis. 66,[68][69][70] VBO is more invasive and may carry a greater risk of complications. 69,71 Cats with bilateral polyps should be staged to reduce the risk of respiratory complications.…”