Feline Ear Polyps

Chronic otitis externa in the cats is usually secondary to an underlying local disorder such as ear mite infestation, extension of an otitis media, ear polyps or neoplasia, or pinnal dermatitis. Unlike what is seen in the dog, otitis externa in cats is less often a clinical manifestation of a generalized dermatogic condition, such as allergy, hypothyroidism, or immune disease. Therefore, initial search for the cause of chronic otitis in the cat is directed first at diseases affecting the local area. When a cause of otitis cannot be found, a full dermatologic workup is indicated. All cats with chronic disease should be serolgically tested for FeLV and FIV.
After a full physical examination of the cat, more carefully examine the pinna, skin around in the region of the ear, and external ear canal orifice. Note any thickening or ulceration of the ear pinna, inflammation or masses around the base of the ear and the consistency of the ear canal. Palpate the submandibular and prescapular lymph nodes to determine if the nodes are enlarged or fixed. These characteristics often suggest neoplastic invasion. Fine needle aspiration and cytology are indicated to further evaluate for the cause of the lymphadenopathy. For a thorough otoscopic examination of the chronic ear, general anesthesia is usually necessary. Before the ear canal is irrigated, look down the canal and search for erythema, exudate, hyperplasia, ulceration, masses, and foreign bodies. Ear swab specimens can be taken for microscopic examination (yeasts, mites, bacteria), and for culture and susceptibility testing in cats with recurrent otitis. Once appropriate specimens are collected, the ear canal is flushed to further examine areas of the ear canal hidden by exudate or soft tissue masses. Be sure to examine the tympanic membrane for abnormalities such as external buldging, masses, inflammation, or more opacity suggesting middle ear involvement. Check the oral and nasopharyngeal area for masses. Examine bulla radiographs for increased density within the bulla indicate a soft tissue mass or fluid. Bone proliferation and bone lysis should be noted indicating infection and/or neoplasia. Thoracic radiographs and incisional biopsy are indicated if neoplasia is suspected. 

Otitis Media and Inflammatory Ear Polyps

Otitis media is an inflammation within the middle ear structures, which include the tympanic membrane, tympanic cavity, auditory tube, ossicles, and tympanic nerve (a small branch of the facial nerve). Otitis media is thought to occur most often as a sequela to otitis externa in dogs; however, it is thought that cats often develop otitis media through the auditory tube as a sequela to upper respiratory disease. Although otitis media can be caused by trauma, foreign bodies, neoplasms, parasites, and bacterial invasion, many young cats presented with middle ear disease have inflammatory polyps. Inflammatory polyps or nasopharyngeal polyps may originate from the pharyngeal mucosa or auditory tube, but, in the author’s experience and others, most arise from the middle ear region. These slowly growing benign fibrous polypoid masses have been reported to extend externally out the external ear canal or through the auditory tube into the nasopharynx. Depending on the route of growth, clinical signs vary. External ear extension results in clinical signs of otitis externa such as otic discharge and head tilt. Polyps that grow into the nasopharynx cause upper respiratory signs such as sneezing, nasal discharge, and, in late stages, dysphagia. [...]