Patient: Phoebe, 7 year old spayed female Britney spaniel.
Presenting complaint: History of chronic external and middle ear infections in both ears. Phoebe has also had vestibular disease (head tilt) toward each side at different times. The right was most effected at this admission, but has previously been surgically treated with a ventral bulla osteotomy and ear canal resection. Allergy testing had not been done.
Endoscopic procedure: Two video-otoscopies were performed on consecutive days. The first was done during sedation and identified a distended tympanic membrane (ear drum) in the right ear. The dog was scheduled for anesthesia in order to do a myringotomy on the next day. At that time, the tympanic membrane was already ruptured in the right ear. The previous ear canal resection had opened up the ear canal sufficiently to be ventilated, even through the ventral flap was raised dorsally. A 2.7 arthroscope and a sialoscope were used to examine the bulla. There was a modest lining of the hyperplastic tissue, but the lumen was not filled. Biopsies were interpreted as chronic-active otitis media, possibly fragments from an inflammatory polyp.
Benefits of using endoscopy: Video-otoscopy provided an excellent view of the middle ear, avoiding a surgical procedure. If the bulla had been filled with tissue, we would have attempted to debride the bulla by this minimally-invasive approach. If unsuccessful, we would have proceeded to a bulla osteotomy only if we were unsuccessful in cleaning out an occlusive mass in the bulla. Management of this dog’s ear problems is probably dependent on the ability to manage her dermatologic disease.
