Total Ear Canal Ablation and Lateral Bulla Osteotomy for Chronic Otitis Externa and Media in Dogs: Postoperative Recovery and Long-Term Follow-up

개에서 만성외이염과 중이염에 대한 전이도 적출술과 외측 고포절골술: 수술 후 회복과정과 장기간 예후

  • Kim, Joon-Young (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Jeong, Soon-Wuk (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Jeong, Man-Bok (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Han, Hyun-Jung (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University) ;
  • Kim, Je-Sun (Department of Veterinary Surgery, College of Veterinary Medicine, KonKuk University)
  • Published : 2003.03.01

Abstract

The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.

전이도적출술 및 외측고포절골술 (total ear canal ablation combined with lateral bulla osteotomy, TECA-LBO)을 행한 10개의 (6마리의 개) 임상결과를 수술 후 회목과정과 장기간 예후를 통해서 평가하였다. 모든 개들은 아래의 다섯가지 소견을 보일 때 TECA-LBO를 실시하였다. 첫째, 적어도 2개월 이상 약물적인 치료가 더 이상 임상증상을 호전시키지 못하는 경우, 둘째, 고막이 완전히 사라진 경우, 셋째, 고포의 방사선밀도가 증가된 경우, 넷째, petrous temporal bone에 경화가 일어난 경우, 다섯째, 이도의 석회화가 진행된 경우. 수술 후 회복경과는 입원 14일 동안, 퇴원 후 7.5개월에 평가하였다. 수술 후 14일째 만성외이염 및 중이염의 증상인 귀를 긁는 것, 통증, 그리고 귀의 경화는 사라졌다. 그리고 이때 수술부위의 종창, 발적, 머리를 기울이는 증상 그리고 Penrose에 의한 삼출물은 모두 사라졌다. 눈을 깜박이지 못하는 것은 4예에서 발생하였고, 이것은 수술 후 14일째 사라졌다. 하지만 한 경우에는 3개월 뒤에 사라졌다. 모든 개들은 수술 후 14일째 퇴원하였다. 퇴원 후 3.5개월에서 6.5개월 사이에 para-aural abscessation이 모든 코커 스파니엘 종에서 발생하여 VBO을 통해 완치시켰다. TECA-LBO를 행하고 para-aural abscessation이 생기지 않은 개들에서는 수술 후 7.5개월 후 귀를 긁는 것, 통증, 귀의 경화가 더 이상 발견되지 않았고, 듣는 능력도 향상되었다. 또한 TECA-LBO를 행하고 para-aural abscessation이 생긴 개들에서는 VBO를 행하고 7.5개월 후 귀를 긁는 것, 통증, 귀의 경화가 더 이상 발견되지 않았고, 듣는 능력도 향상되었다. 결론적으로 전이도적출술 및 외측고포절골술은 적용한 후 약 2주 정도의 치료 경과를 보였고 치료 후 코커 스파니엘종을 제외하고는 별다른 합병증 없이 좋은 회복을 보였다. 그리고 수술 후 눈을 깜박이지 못하는 것은 수술 후 약 2주안에 자연적으로 사라졌다. 그리고, para-aural abscessation은 수술 후 4개월에서 7개월 사이에 발생하므로 follow-up 은 8개월까지 이루어져야 한다.

Keywords

References

  1. J Am Anim Hosp Assoc v.11 Lateral approach to bulla osteotomy Barrett RE;Rathfon BL
  2. J Am Vet Med Assoc v.196 Total ear canal ablation combining bulla osteotomy and curettage in dogs with chronic otitis externa and media Beckman SL;Henry WB;Cechner P
  3. Probl Vet Med v.3 Surgery of the tympanic bulla(Otitis media and Nasopharyngeal polyps) Boothe HW
  4. Vet Surg v.25 Comparison of three methods for relief of pain after ear canal ablation in dogs Buback JL;Boothe HW;Carroll GL(et al.) https://doi.org/10.1111/j.1532-950X.1996.tb01431.x
  5. J Small Anim Pract v.42 Para-aural abscessation following traumatic ear canal separation in a dog Connery NA;McAllister H;Hay CW https://doi.org/10.1111/j.1748-5827.2001.tb02031.x
  6. Vet Surg v.26 Passive drainage versus primary closure after total ear canal ablation-lateral bulla osteotomy in dogs: 59 dogs (1985-1995) Devitt CM;Seim HB 3rd;Willer R(et al.) https://doi.org/10.1111/j.1532-950X.1997.tb01486.x
  7. Textbook of Small Animal Surgery(2nd ed.) Douglas HS. Ear
  8. Probl Vet Med v.3 Surgery of the external ear canal Elkins AD
  9. Small Animal Surgery(2nd ed.) Surgery of the ear Fossum TW
  10. J Small Anim Pract v.10 Canine ear disease Frasier G;Gregor WW;Mackenzie CP(et al.) https://doi.org/10.1111/j.1748-5827.1969.tb04013.x
  11. Small Animal Ear Diseases Anatomy of the canine and feline ear Gotthelf LN
  12. Small Animal Ear Diseases Examination of the external ear canal Gotthelf LN
  13. Small Animal Ear Diseases Otitis Media Gotthelf LN
  14. Small Animal Ear Diseases Healing of the Ruptured Eardrum Gotthelf LN
  15. Aust Vet J v.38 The surgical treatment of canine otitis externa Grono LR https://doi.org/10.1111/j.1751-0813.1962.tb16048.x
  16. J Am Vet Med Assoc v.177 Ear canal disease in the dog: medical and surgical management Harvey CE
  17. Ear Diseases of the Dog and Cat(1st ed.) Diagnostic Procedures Harvey RG;Harari J;Delauche AJ
  18. Ear Diseases of the Dog and Cat(1st ed.) Otitis Media, Otitis Interna Harvey RG;Harari J;Delauche AJ
  19. Ear Diseases of the Dog and Cat(1st ed.) Para-Aural Abscess Harvey RG;Harari J;Delauche AJ
  20. Ear Diseases of the Dog and Cat(1st ed.) Surgical Resection,Aural Ablation,and Bulla Osteotomy Harvey RG;Harari J;Delauche AJ
  21. J Am Vet Med Assoc v.202 Effect of total ablation of the external acoustic meatus and bulla osteotomy on auditory function in dogs Krahwinkel DJ;Pardo AD;Sims MH;Bubb WJ
  22. Vet Surg v.17 Total ear canal ablation combined with lateral bulla osteotomy for end-stage otitis in dogs. Results in thirty dogs Mason LK;Harvey CE;Orsher RJ https://doi.org/10.1111/j.1532-950X.1988.tb01012.x
  23. J Am Anim Hosp Assoc v.26 Total ear canal ablation and lateral bulla osteotomy in 38 dogs Matthieson DT;Scavelli T
  24. Vet Surg v.24 Wound healing and brain stem auditory evoked potentials after experimental total ear canal ablation with lateral tympanic bulla osteotomy in dogs McAnulty JF;Hattel A;Harvey CE https://doi.org/10.1111/j.1532-950X.1995.tb01285.x
  25. J Am Vet Med Assoc v.168 Bulla curettage for chronic otitis media and interna in dogs Parker AJ;Schiller AG;Cusick PK
  26. J Am Vet Med Assoc v.133 Treatment of chronic canine otitis externa by ablation of the ear canal Seward CO;Blackmore WM;Ott RL
  27. J Am Vet Med Assoc v.209 Treatment of recurrent otitis media that developed after total ear canal ablation and lateral bulla osteotomy in dogs: nine cases (1986-1994) Smeak DD;Crocker CB;Birchard SJ
  28. Vet Surg v.15 Total ear canal ablation-clinical results in the dogs and cat Smeak DD;DeHOFF WD https://doi.org/10.1111/j.1532-950X.1986.tb00197.x
  29. Semin Vet Med Surg (Small Anim) v.8 Total ear canal ablation and lateral bulla osteotomy for management of end-stage otitis Smeak DD;Kerpsack SJ
  30. Vet Surg v.19 Chronic otitis externa and otitis media treated by total ear canal ablation and ventral bulla osteotomy in thirteen dogs Sharp DJH https://doi.org/10.1111/j.1532-950X.1990.tb01159.x
  31. Vet Rec v.142 Evaluation of the canine tympanic membrane by positive contrast ear canalography Trower ND;Gregory SP;Renfrew H;Lamb CR https://doi.org/10.1136/vr.142.4.78
  32. Am J Otol v.16 Chronic tympanic membrane perforation: an animal model Truy E;Disant F;Morgan A
  33. Am J Vet Res v.16 Operation for otitis externa in dogs according to zepps method Tufvesson E
  34. J Am Vet Med Assoc v.214 Wound contamination and antimicrobial susceptibility of bacteria cultured during total ear canal ablation and lateral bulla osteotomy in dogs Vogel PL;Komtebedde J;Hirsh DC(et al.)