Diagnosis & Treatment of an Aural Polyp Using Video Otoscopy

Diagnosis & Treatment of an Aural Polyp Using Video Otoscopy

felineearpolypA cat presented for pawing and scratching at his ear for several weeks duration. The OtoPet-USA Video VetScope was used to perform an otoscopic exam and this picture of the cat’s aural polyp was taken and documented for records.

The cat was placed under general anesthesia and the polyp was again visualized using the OtoPet-USA Video VetScope. Once visualized, forceps were used with video guidance to grasp and extract the polyp using the traction and avulsion method, which will be discussed below.

This cat was sent home on topical steroids to help prevent re-growth, and oral antibiotics – as secondary bacterial infections are commonly associated with aural polyps.

Aural polyps may be found in a cat’s ear when they have clinical signs that include head shaking, pawing or scratching at the ear, nystagmus, head tilt, otic exudate, ataxia and Horner’s syndrome. They may also be found in a non-clinical cat’s routine exam using an otoscope.

Polyps are benign, fleshy masses that may be found in the nose, nasopharynx, middle ear, and/or external ear canal. The exact cause of polyps is unknown.

Upon examination of the ear canal using an otoscope, an aural polyp appears as a smooth, pink mass. They may also appear red or white, or be covered in blood or mucous. The tympanic membrane may appear discolored or distorted if the polyp is located in the middle ear.

catbullaIf a polyp is suspected in the middle ear, then open-mouth skull radiographs may be taken and can show increased density within one of the bulla and in the horizontal ear canal. To the left is a radiograph of a bulla showing some opacity that is consistent with a polyp in the right middle ear. This radiograph was copied using the OtoPet-USA Video VetScope full image lens.

Aural polyps may be removed by steady traction and twisting of the polyp with forceps while that cat is under anesthesia and while using videoscopy. The stalk of the polyp should be removed as well. Curved forceps are inserted into the ear canal, and the mass is grasped and extracted with traction. Polyps that are more fibrous or difficult to reach may require a ventral bulla osteotomy for removal. A ventral bulla osteotomy for removal of aural polyps has a much lower recurrence rate than the traction and avulsion technique.

After removal, oral antibiotics should also be given based on bulla cultures, and oral anti-inflammatory doses of steroids should be given for several weeks to reduce the incidence of re-growth. Topical high dose steroids and antibiotics may be used as well.

If you have an interesting case that you would like to submit with pictures, please contact Dr. Jessica Melman Bhatia at jessvet3@aol.com.