Ear surgery: minimal invasive approach

Introduction

Whereas most ear diseases, when they require surgical intervention, will necessitate quite invasive surgery such as total ear canal ablation or ventral bulla osteotomy to completely eradicate the initiating problem, middle ear polyps in cats can often be removed using less invasive techniques. These techniques, however, only focus on eliminating the clinical signs of outer ear canal or nasopharyngeal disease and do not address possible underlying predisposing abnormalities in the middle ear. Other diseases of the ear may truly only require a minimal invasive approach for effective treatment. Examples of the latter include endoscopic ear canal surgery (removal of small tumors), endoscopy guided myringotomy techniques and endoscopy guided placement of ventilation tubes for middle ear effusion in certain selected cases.

Middle ear polyps

Middle ear polyps in cats are relatively common masses arising from the mucosal lining of the middle ear, Eustachian tube or the nasopharynx^1-3. The treatment of middle ear polyps that have protruded beyond the middle ear cavity into the ear canal is surgical in all cases. Described techniques include traction-avulsion, transtympanic endoscopic traction-avulsion, ventral bulla osteotomy, lateral ear resection, and total ear canal ablation with lateral bulla osteotomy^4,5. Endoscopically guided resection in the author’s opinion is especially helpful and successful when dealing with relative small protruding polyps that are at the level of the eardrum or horizontal ear canal. With the technique described below however, a relatively minimal invasive approach with a vertical incision in the ear canal after a lateral approach to the ear canal, low recurrence rates, especially by experienced surgeons can be achieved ^6,7 . [...]