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Otitis Externa
Exam 1
20
Veterinary Medicine
Professional
09/18/2016

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Term
What is otitis externa?
Definition
-inflammation of the ear canal and adjacent inner surface of the pinnae
Term
What are some predisposing factors to otitis externa?
Definition
-increased environmental temperature and/or moisture
-grooming practices
-anatomic variations: floppy ears, stenotic canals, hair
-systemic or immunosuppressive diseases
-Breed predisposition: Spaniels, Retrievers, German shepherds, Bull dogs
Term
What are the primary factors leading to otitis externa?
Definition
-foreign bodies
-hypersensitivity disorders: atopy, food allergy, contact llaergic reaction
-Ectoparasites: ear mites, ticks, mites
-keratinization disorders: primary idiopathicseborrhea
-neoplasia
Term
What are some perpetuating factors of otitis externa?
Definition
-bacterial and yeast overgrowth
-progressive pathology of the ear canal: edema, hyperkeratosis, epi hyperplasia, fibrosis, exudate, mineralization
-otitis media
-treatment errors
Term
What are the clinical signs of otitis externa?
Definition
-shaking head
-scratching and rubbing ears
-painful ears
-head tilt
-ear discharge and/or odor
Term
Describe the diagnostic plan of otitis externa?
Definition
-Find primary cause: allergy for isntance, ectoparasites
-examine both ears
-cytology of exudate
-otoscopic examinaton
-Bacterial C&S
-blood profiling
Term
What are the clinical considerations of otitis externa?
Definition
-severely painful and ulcerated canals
-copious discharge: ear cleaning
-restraint: physical, sedation, anesthesia
Term
What do we use for pretreatment of otitis externa?
Definition
-topical and systemic corticosteroids for 3-5 days
Term
Why is ear cleaning important?
Definition
-essential for successful treatment and good visualization of canal/tympanic membrane
Term
What kinds of solutions are used for ear cleaning?
Definition
-weak acids: acetic, boric, lactic, tc
-antiseptics (benzyl alcohol, povidone iodine, chlorhexidine, benzalkonium choride
-cerumonolytics: squalene, DSS, mineral oil
-vehicles: squalene, mineral oil, propylene glycol, water
Term
Describe deep ear cleaning.
Definition
-otoscope with surgical head or vdeo otoscope
-warm sterile 0.9% saline with chlorhexidine soap
-pediatric rubber bulb
-soft rubber urinary catheter
-12 cc syringe
-alligator forceps
-ear currettes
-topical corticosteroids
-anesthesia
Term
What is absolute necessary for myringotomy?
Definition
-direct visualization of the eardrum
Term
What are the possible complications of myringotomy?
Definition
-vestibular disease
-deafness
Term
What are major bacterial agents of otitis externa?
Definition
***S. pseudintermedius, Pseudomonas aeruginosa
-Proteus mirabilis, E. coli, Corynebacterium spp, Enterococcus spp, Streptococcus spp
Term
What do we use to treat Pseudomonas off label?
Definition
-Enrofloxacin solution
-Amikacin sulfate
-Polymyxin B
-Gentamycin sulfate
-Silver suldiazine
-Tris-EDTA
Term
Describe systemic antibiotic therapy for bacterial overgrowth leading to otitis externa,
Definition
-6-8 weeks or longer
-Pseudomonas drug resistance can be an issue
-can also use Cephalexin, Chloramphenicol, Fluoroquinolones, Aminoglycosides
Term
What are the clinical signs of syringomyelia/Chiar-like malformation?
Definition
-ataxia
-head tilt
-nystagmus
-facial paralysis
-hearing loss/deafness
-pain around head, scratching at ears
-ear drum bulges outward
Term
How do we treat otitis media?
Definition
-myringotomy
-flush middle ear
-ear tubes
-tends to recur
Term
Which species most commonly affected by polyps?
Definition
-cats
Term
What are the clinical signs of ear polyps? HOw do we treat them?
Definition
-same as otits externa/media
-surgical removal
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