Waxy Ear
In order to effectively manage cases of otitis it is very important to thoroughly clean the ear canals. It is often the most important step in managing otitis, as cases may become chronic without proper cleaning. In order to effectively clean ears the OtoPet-USA Earigator should be used for lavage and suction of the ear canal to remove debris along with the OtoPet-USA Video VetScope, which allows for visualization of the ear canal.
It is extremely important to clean out excessive or abnormal debris when managing cases of otitis. Debris can block the penetration of topical agents to the affected tissue requiring treatment, and large deposits may prevent medication from reaching the deeper parts of the ear canal. Larger clumps of debris that remain in the ear canal may sequester organisms as well. Debris can also protect microbes that are attached to keratinocytes, and therefore, covered with a protective lipid layer. These organisms may survive therapy and then infect the ear again. Retained debris may also contain pro-inflammatory substances, such as microbial byproducts and toxins. Additionally, purulent discharge may interfere with the effectiveness of some antibiotics. Finally, it is often necessary to clean the ear of debris simply to be able to properly to visualize the tympanum.
Below is a case study demonstrating the use of the Earigatorand Video VetScope to clean an ear with excessive debris.
In this case, the patient was placed under general anesthesia, which is required for a through otic flushing. An endotracheal tube was placed and the patient was positioned in lateral recumbency.
The ear canal was visualized using the Video VetScope. If needed, samples for cytology, culture and sensitivity should be collected and imaging studies should be performed prior to flushing the ear canal.
The type of discharge in the ear directs the selection of an appropriate initial flush. If the discharge is waxy, a cleaner with good ceruminolytic properties should be used. If the discharge is mucoid and purulent, an aqueous cleaner is preferable.
Copious flushing of the ear canal with a warmed aqueous flush should be performed after the initial flush to remove any residual ear cleanser and minimize any irritation or adverse reaction from the cleanser. Flushing also helps to remove debris.
A ceruminolytic cleanser was initially instilled into this ear to break up the thick cerumen. This was followed by a warm aqueous flush using the Earigator. See directions below on how to use the Earigator.
Finally, the ear was evaluated again with the Video VetScope to ensure it was clean. Alligator forceps inserted through the Video VetScope probe may be used to remove any excess debris if needed as well. In this case most of the debris was removed with the Earigator and a few residual pieces required removal with forceps.
If you have an interesting case that you would like to submit with pictures, please contact Dr. Jessica Melman Bhatia at jessvet3@aol.com.
To read and view previous Case Studies, visit the Case Studies Blog at www.OtoPet-USA.com.