PREVALENCE AND CHARACTERIZATION OF SMALL TYMPANIC BONE SPICULES AND DRUMSTICK‐LIKE HYPEROSTOTIC TYMPANIC BONE SPICULES IN THE MIDDLE EAR CAVITY OF DOGS

Rounded, sessile, hyperattenuating structures detected in computed tomography (CT) studies of canine tympanic bullae have been termed “otoliths.” These have been proposed to represent dystrophic mineralizations or heterotopic bone formations in the middle ear that are potentially related to chronic otitis media. Aims of the current study were to describe the prevalence, macroscopic, and histological features of structures consistent with “otoliths” in the canine tympanic cavity. Tympanic bullae from 50 routinely necropsied dogs and 139 retrospectively retrieved CT scans of canine clinical cases were examined. Small tympanic bone spicules with pointed or clubbed tips essentially arising from the free margin of the septum bullae were bilaterally present in the tympanic cavities of all 50 of the necropsied dogs. In 48% of the dogs, “otolith”‐like CT‐detectable bone spicules carrying drumstick‐like hyperostoses that were 1–6 mm in diameter were also present. In the retrospective survey of bulla CT scans of 139 cases, the prevalence of hyperostotic tympanic bone spicules (HTBS) was 20%. Findings from the current study indicated that the presence of small tympanic bone spicules in adult dogs is most likely due to physiological bone growth in the septum bullae and that HTBS represent osseous proliferations of small tympanic bone spicules. However, the factors inducing formation of hyperostotic spicules from small tympanic bone spicules remain unknown. The high prevalence of HTBS displaying a similar appearance in bulla CT scans in dogs suggests that these spicules should be included in a differential diagnosis list for “otoliths.”     

Computed tomographic features of feline nasopharyngeal polyps

The computed tomographic (CT) findings of histopathologically confirmed nasopharyngeal polyps are described in 13 cats. Most polyps were mildly hypoattenuating to adjacent muscles and isoattenuating to soft-tissue (n= 13), homogeneous (n = 12) and with ill-defined borders (n = 10) on precontrast images. After contrast medium administration, the polyps were homogeneous (n = 11), with well-defined borders (n = 13), oval (n = 13), and had rim enhancement (n = 13). Nasopharyngeal polyps were pedunculated in 11 cats with a stalk-like structure connecting the polyp through the auditory tube to an affected tympanic bulla. All cats had at least one tympanic bulla severely affected, with CT images identifying: (1) complete (n = 12) or partial (n = 1) obliteration of either the dorsal or ventral compartments with soft-tissue attenuating material; (2) pathologic expansion (n = 13) with wall thickening (n = 10) that was asymmetric in nine cats; and (3) identification of a polyp-associated stalk-like structure (n = 11). Nine cats had unilateral tympanic bulla disease ipsilateral to the polyp, and four cats had bilateral tympanic bulla disease, most severe ipsilateral to the polyp with milder contralateral pathologic changes. Two cats had minimal osteolysis of the tympanic bulla. Enlargement of the medial retropharyngeal lymph node was seen commonly (n = 8), and in all cats it was ipsilateral to the most affected tympanic bulla. One cat had bilateral lymphadenopathy. CT is an excellent imaging tool for the supportive diagnosis of nasopharyngeal polyps in cats. CT findings of a well-defined mass with strong rim enhancement, mass-associated stalk-like structure, and asymmetric tympanic bulla wall thickening with pathologic expansion of the tympanic bullae are highly indicative of an inflammatory polyp.     

Effect of tympanic cavity evacuation and flushing on microbial isolates during total ear canal ablation with lateral bulla osteotomy in dogs

OBJECTIVE: To evaluate differences in bacterial numbers, identity, and susceptibility in samples obtained from the tympanic cavity on entry (preflush) and after evacuation and lavage (postflush) and assess perioperative and empiric antimicrobial selection in dogs that underwent total ear canal ablation (TECA) with lateral bulla osteotomy (LBO) or reoperation LBO. DESIGN: Prospective clinical study. ANIMALS: 34 dogs. PROCEDURE: TECA with LBO or reoperation LBO was performed on 47 ears. Pre- and postflush aerobic and anaerobic samples were obtained from the tympanic cavity. Isolates and antimicrobial susceptibility patterns were compared. RESULTS: Different isolates (31/44 [70%] ears) and susceptibility patterns of isolate pairs (6/44 [14%] ears) were detected in pre- and postflush samples from 84% of ears. Evacuation and lavage of the tympanic cavity decreased the number of bacterial isolates by 33%. In 26% of ears, bacteria were isolated from post-flush samples but not preflush samples. Only 26% of isolates tested were susceptible to cefazolin. At least 1 isolate from 53% of dogs that received empirically chosen antimicrobials postoperatively was resistant to the selected drugs. Anaerobic bacteria were recovered from 6 ears. CONCLUSIONS AND CLINICAL RELEVANCE: Accurate microbiologic assessment of the tympanic cavity should be the basis for selection of antimicrobials in dogs undergoing TECA with LBO. Bacteria remain in the tympanic cavity after evacuation and lavage. Cefazolin was a poor choice for dogs that underwent TECA with LBO, as judged on the basis of culture and susceptibility testing results.     

Wound Healing and Brain Stem Auditory Evoked Potentials After Experimental Ventral Tympanic Bulla Osteotomy in Dogs

Ventral tympanic bulla osteotomy was performed in 13 normal dogs to evaluate healing and retention of brain stem auditory evoked potentials (BSAEP). Healing was evaluated by gross and microscopic examination of the middle ears after 1 (n = 2), 4 (n = 8), 5 (n = 1), and 6 (n = 1) weeks. One dog was eliminated from the study. Brain stem auditory evoked potentials were measured using an air-conducted sound stimulus before and after surgery and before killing. Nine of 12 dogs re-formed the tympanic bulla by formation of fibrous connective tissue lined with cuboidal epithelium in the osteotomy site. Four of the nine dogs had a reduced tympanic bulla volume (estimated 20% to 40% volume reduction) caused by soft tissue ingrowth through the osteotomy. Nine of 12 dogs had proliferation of subperiosteal new bone from the inner surface of the tympanic bulla that varied in severity. Three of these nine dogs had nearly complete obliteration of the tympanic cavity by proliferating subperiosteal new bone. Eight dogs had nodules of granulation tissue containing new bone and mineralization diffusely distributed on the surfaces of the middle ear. The measured BSAEP sensitivity before killing was equivalent to preoperative levels in 11 dogs. The remaining dog had no change in auditory sensitivity after surgery but had a markedly reduced BSAEP detection threshold before killing. This appeared to be attributable to mechanical impingement on the ossicles and tympanic membrane by proliferating bone within the tympanic cavity. This study showed that after ventral tympanic bulla osteotomy the tympanic bulla rapidly re-forms with no deleterious effect on hearing in most dogs treated. However, the internal surfaces of the middle ear appear to be sensitive to surgical trauma, and extensive new bone proliferation is easily induced. This response may be extreme, resulting in middle ear obliteration and reduced auditory sensitivity.     

Differences between µCT‐imaging and conventional CT for the diagnosis of possible diseases of the middle and inner cat ear

The aim of this study was to check the relevance of using in‐vivo micro computed tomography (µCT) for the diagnosis of possible diseases of the middle and inner ear of the cat. Therefore, on the one hand, differences of the detail detectability between the two imaging methods conventional computed tomography (cCT) and in‐vivo µCT were analyzed. Six healthy cat ears were dissected and scanned several times and the obtained images were compared with each other. On the other hand, histological slices of all ears were prepared and pictures of defined anatomical structures were taken and compared with the identical sectional plane of the µCT‐images. This way it was possible to evaluate the quality and clinical limitations of the in‐vivo µCT. The results show that an in‐vivo µCT is suitable to analyze even the smallest osseous structures, such as the semicircular ducts, the spiral osseous lamina or the ossicles whereas with the help of cCT it is not possible to identify such small osseous structures because of their blurred and less detailed representation. Delicate soft tissue structures as the membranous labyrinth including hearing and vestibular organ cannot be differentiated with as well in‐vivo µCT‐ as with cCT‐images. In‐vivo µCT represent a good possibility for more detailed diagnosis of extremely fine structures which cannot be detected with cCT. Histological slices can nonetheless not be replaced by in‐vivo µCT due to a too low spatial resolution and the limitations of the in‐vivo µCT with regard to the evaluation of soft tissue dense structures.     

Congenital malformations of the external and middle ear accompanied by temporal bone anomaly in a calf

A 7-month-old female Holstein calf presented with bilateral microtia and absent external acoustic meatus. The real-time polymerase chain reaction test was negative for bovine viral diarrhea virus and bovine leukemia virus. The calf’s dam had a normal reproductive history. Computed tomography confirmed bilateral atresia of external auditory canals, aplasia of tympanic cavities and the ossicular chain, and temporomandibular joint abnormality. Necropsy revealed a severe malformation of the temporal bone. In the tympanic region, the external acoustic pore, tympanic bulla, and muscular process were absent bilaterally. The bilateral inner ear structure was normal. Based on these findings, we diagnosed the present case as congenital malformations of the external and middle ear accompanied by temporal bone anomaly.     

Virtual otoscopy for evaluating the inner ear with a fluid-filled tympanic cavity in dogs

The feasibility of virtual otoscopy (VO) imaging was evaluated in five dogs with experimentally induced otitis media, two control dogs, and two canine patients with otitis media. VO images of the tympanic cavity and ossicles were generated with commercially available software using raw computed tomography (CT) data. Eight out of 10 ears inoculated with pathogen exhibited obvious clinical signs associated with otitis externa. CT images revealed soft tissue density material occupying the tympanic bulla compatible with otitis media in three dogs with experimentally induced otitis media and two patients. No remarkable features were observed on the radiographs. Four different VO views (ear canal, tympanic bulla, eustachian tube, and ossicular chain) were created. Promontory, cochlea window, tympanic, and septum bulla as well as ossicles were easily and clearly distinguished except for the incus and stapes of the clinical patients. VO images were not more suitable than images created with conventional CT for accurately diagnosing otitis media in this study. However, it appears that VO could be more feasible for assessing the complex structure of the inner ear in dogs with fluid-filled tympanic cavities since fluid accumulation within the tympanic bulla did not affect the evaluation of bony tissue in the middle ear on VO images.     

COMPUTED TOMOGRAPHY FEATURES OF MIDDLE EAR CHOLESTEATOMA IN DOGS

We describe the computed tomography (CT) findings in 11 dogs with middle ear cholesteatoma. The cholesteatoma appeared as an expansile tympanic cavity mass with a mean attenuation value of 55.8±4.2 Hounsfield units. There was no appreciable contrast enhancement of the tympanic bulla contense but ring enhancement was seen in four dogs. Due to the slow progressive growth, the lesion causes severe bone changes at the contour of the tympanic bulla, including osteolysis, osteoproliferation and osteosclerosis, expansion of the tympanic cavity, and sclerosis or osteoproliferation of the ipsilateral temporomandibular joint and paracondylar process. Cholesteatoma can cause lysis of the petrosal part of the temporal bone, leading to intracranial complications. Although not definitive, CT provides useful information for distinguishing a middle ear cholesteatoma from otitis media and neoplasia. In otitis media, enlargement of the tympanic cavity is not routinely observed. In tumors that primarily affect the middle or inner ear, the predominant signs are lysis of the contour of the tympanic bulla or the petrosal part of the temporal bone, soft tissue swelling around the middle ear and marked contrast enhancement. In tumors that arise from the external ear, a soft tissue mass is visible within the external acusticus meatus, and the middle ear is only involved secondarily.     

Wound Healing and Brain Stem Auditory Evoked Potentials After Experimental Total Ear Canal Ablation With Lateral Tympanic Bulla Osteotomy in Dogs

Experimental total ear canal ablation with lateral tympanic bulla osteotomy (TECA-LBO) was performed in 13 normal dogs to evaluate healing and retention of brain stem auditory evoked potentials (BSAEP) after surgery. Healing was evaluated by gross and microscopic examination of the surgery sites after 1 (n = 2), 4 (n = 8), 5 (n = 1), and 6 (n = 1) weeks. One dog was eliminated from the study. Brain stem auditory evoked potentials were measured using an air-conducted sound stimulus before and after surgery and before killing. Two dogs had nearly complete obliteration of the tympanic cavity by immature fibrous connective tissue. Eight dogs responded to surgery by either complete or partial re-formation of the tympanic cavity. Retention of the tympanic membrane in three dogs promoted re-formation of the tympanic cavity and blind epithelialized pockets in the surgery site with accumulation of keratinized debris. Granulation tissue formation and extensive proliferation of new bone on the internal surface of the tympanic bulla was seen in 10 dogs. Proliferative bone completely obliterated the tympanic cavity in two of these dogs. Eleven of 13 dogs had no detectable air-conducted BSAEP after surgery. There was no change in BSAEP measurements before killing compared with postoperative measurements in any dog. Two dogs with retained tympanic membranes had measurable BSAEP after surgery. This study shows that healing after TECA-LBO may be highly variable. Retention of the tympanic membrane and small osteotomies appeared to promote reformation of tympanic cavities and prevent ingrowth of granulation tissue. New bone proliferation was frequently observed in response to curettage of the epithelium lining the tympanic bulla. Hearing, as determined by BSAEP measurements, was lost except when the tympanic membrane and ossicles were retained. Retained tympanic membranes promoted accumulation of keratinized cellular debris that could become a nidus for infection or late abscessation in some dogs. These results indicate that resection of as much of the lateral and ventral tympanic bulla as possible and removal of the tympanic membrane may provide consistently improved results after TECA-LBO.     

CANALOGRAPHIC EVALUATION OF THE EXTERNAL EAR CANAL IN DOGS

Canalography was performed to measure the diameter of the horizontal ear canal and to assess the clinical relevance of the measurements in identifying abnormalities of the ear canal. The diameter of the proximal and distal end of the annular cartilage in the horizontal ear canal was measured using canalography in 222 ears. The tympanic membrane could not be visualized with otoscopic examination in 70 ears even after ear cleansing. These canals were classified as being stenotic. The diameter of the proximal annular cartilage in the stenotic canals ranged from 0.8 to 3.1 mm (mean = 2.6 +/- 0.8 mm). The proximal annular cartilage was consistently smaller in diameter than the distal annular cartilage. The ratio between the diameter of the proximal and distal annular cartilage varied between dogs. In stenotic ear canals (70 ears) the ratio was less than 0.65. Total ear canal ablations and histopathological analysis were performed in 70 ear canals classified as stenotic after canalography. Hyperplasia of the epidermal layer was found in 56 stenotic canals. Stenosis of the canal due to otitis externa was found in the other 14 canals. Three canals with severe otitis externa were also diagnosed with canalography as having a ruptured tympanic membrane. The results suggest that canalography can be used to measure the diameter of the horizontal ear canal and to assess whether or not the tympanic membrane is ruptured prior to conservative or surgical therapy.     

COMPUTED TOMOGRAPHIC APPEARANCE OF INFLAMMATORY POLYPS IN THREE CATS

This report describes the use of computed tomography (CT) to evaluate the inner ear, tympanic bullae, nasopharyngeal area, and external ear canals of three cats. All cats presented for evaluation of upper respiratory signs or chronic ear infection. Nasopharyngeal masses were present in two cats, and a mass in the external ear canal was present in the third cat. In all three cats, CT was able to define the extent of osseous bulla involvement, which was confirmed at surgery. Computed tomography also defined the extent of the polyp in the nasopharyngeal area in two cats, and in the external ear canal in one cat. Surgical removal of the polyps was accomplished with a combined oral approach and ventral bulla osteotomy in cats 1 and 2. The polyp was removed from cat 3 using a combination of ventral bulla osteotomy and excision of the mass through the external ear canal. Microscopic examination confirmed all masses as nasopharyngeal (inflammatory) polyps.     

Comparison of bone healing,as assessed by computed tomography,following tibial tuberosity advancement in dogs with and without autogenous cancellous bone grafts

Abstract

AIMS: To objectively compare measures of bone healing, using computed tomography (CT) in dogs following bilateral tibial tuberosity advancement (TTA), between tibiae treated with and without autogenous cancellous bone grafts.

METHODS: Ten dogs with bilateral cranial cruciate ligament disease requiring surgical stabilisation were prospectively recruited to undergo single-session bilateral TTA, with only one, randomly assigned, tibia receiving bone graft in the osteotomy deficit. Bone healing at the osteotomy site was assessed using CT performed 38–70 days post-operatively. CT images were evaluated using both objective measurements of osseous bridging and subjective evaluation by six radiologists. Repeated measures ANOVA was used to compare the objective outcomes between the grafted and non-grafted tibiae.

RESULTS: The mean percentage of the osteotomy deficit bridged at the lateral cortex was greater in grafted (77.6, SD 35.2%) compared to non-grafted (63.0, SD 36.5%) tibiae (p=0.001), but did not differ at the medial cortex (p=0.1). The mean minimum callus width was greater in grafted (7.2, SD 3.3 mm) compared to non-grafted (3.6, SD 2.9 mm) tibiae (p<0.001). There was no difference in mean attenuation (measured in Hounsfield units) of the callus between grafted and non-grafted tibiae (p=0.5). The grafted tibia was deemed to have superior bone healing in 50/60 subjective assessments made by radiologists.

CONCLUSIONS: Superior osseous bridging was detected by CT analysis following TTA using autogenous cancellous bone grafts compared with no graft. This was shown by greater bridging percentage at the lateral cortex and formation of a broader callus. Qualitative assessments made by six radiologists also supported the conclusion that bone healing was improved by use of autogenous cancellous bone graft. CT was a useful method for assessing evidence of bone healing following TTA.

CLINICAL RELEVANCE: These findings justify the application of autogenous cancellous bone graft to augment healing following TTA in dogs.     

Inflammatory middle ear disease of the dog: the pathology of otitis media

Inflammation within the middle ear cavity was recognised in 62 of the ears of 42 dogs with chronic otitis externa and otitis media, after biopsy or necropsy of the middle ear. The pathological changes in the middle ear resembled those reported in other species or after the experimental induction of otitis media in dogs. Perforations in the tympanic membrane were rarely found; on the contrary, the membrane was often thickened. However, the question of whether a perforation in the tympanic membrane must occur before otitis externa can extend to otitis media was not resolved.     

ULTRASONOGRAPHIC EVALUATION OF THE EXTERNAL EAR CANAL AND TYMPANIC MEMBRANE IN DOGS

Ultrasonographic imaging of the canine external ear canal, tympanic membrane, and tympanic bulla was described in five healthy beagle dogs before and after infusion of saline into the ear canal. Saline served as an acoustic window. With this method, the external ear canal, and tympanic bulla were visible in the same imaging plane and the integrity of the tympanic membrane could be evaluated indirectly by confirming an intact tympanic membrane, which appeared at the end of the ear canal as a hyperechoic line with reverberation. Experimentally, perforated tympanic membrane could be evaluated by identifying anechoic saline in the tympanic bulla lumen. The air and fluid-filled tympanic bulla were also visualized. Ultrasonography with saline as an acoustic window appears to be helpful for the evaluation of the external ear canal, tympanic membrane, and tympanic bulla and it may have the potential to be a useful clinical tool in evaluation of integrity of the tympanic membrane.     

Origin and distribution of facial nerve anatomy in van cats

This study aims to reveal the morphological properties of facial nerve and the middle ear in Van cats. Study material was composed of 6 female Van cats. Dissections were performed under a Zoom Stereo Microscope. There was no plexus buccalis in Van cats. The chorda tympani was observed to pass through an opening in the tympanic cavity, emerge through a small opening just behind the retroarticular process, and join the lingual nerve. A rounded anatomical formation with a size of 2.75 ± 0.3 mm was found to be located within the mastoid process of the temporal bone between the facial nerve and the auricular branch of the vagus nerve. The stapes nerve was not present. The geniculate ganglion was very prominent and about 1.00 mm high. The deep petrosal nerve was observed to emerge from the plexus tympanicus. The bulla tympanica was 18.96 ± 0.10 mm long, 13.03 ± 0.20 mm wide and 13.16 ± 0.20 mm high. After leaving the mandibular nerve, the n.tensoris tympani coursed caudally around the a.maxillaris, formed an ansa, entered the tympanic cavity through the canalis musculotubarius and reached an end in the m. tensor tympani. Due to the scarcity of studies on the middle ears of Van cats, it is thought that this study will fill a gap in the field of veterinary anatomy.     

The association of Pityrosporum pachydermatis with the normal external ear canal of dogs and cats

The frequency of Pityrosporum pachydermatis within the non-otitic external ear canals of dogs and cats has been investigated and an assessment of the abundance of the yeast made by microscopic and cultural techniques. It was present in varying amounts in 49% of clean dog ears and 23% of clean cat ears. Microscopically, 14% of the ears were found to contain the yeast in large numbers. A further 3 % of ears examined showed excessive cerumen production and all these contained the yeast.
The prevalence of P. pachydermatis in non-otitic ears of both dogs and cats was similar to that previously reported in otitic ears.     

Evaluation of T lymphocytes in captive african lions (Panthera leo) infected with feline immunodeficiency virus

OBJECTIVE: To determine whether FIV infection in captive African lions is associated with changes in immune cell variables similar to those detected in domestic cats infected with FIV. ANIMALS: 5 captive African lions naturally infected with FIV (FIV+) and 5 lions not infected with FIV (FIV-). PROCEDURE: Peripheral blood samples were collected from FIV+ lions during annual examinations conducted during a 7-year period and at a single time point from the FIV- lions. From results of CBC and flow cytometry, lymphocyte subsets were characterized and compared. RESULTS: Flow cytometric analysis revealed that the percentage and absolute number of CD4+ and CD8+ T cells were significantly lower in FIV+ lions, compared with these values in FIV- lions. In FIV+ lions, severe depletion in the absolute number of CD4+ and CD8+ T cells was detected, although this did not correlate with clinical signs. Muscle wasting was the most consistent clinical sign of infection. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that FIV+ African lions develop lymphocyte deficiencies, including significant decreases in the absolute number of CD4+ and CD8+ T cells; these findings of immune dysfunction are similar to those defined for FIV+ domestic cats. It is important to monitor the number of CD4+ T cells in infected animals as a measure of disease progression.     

Soft palate hypoplasia and concurrent middle ear pathology in six dogs

This retrospective clinical study describes six consecutive cases of bilateral hypoplasia/malformation of the soft palate in dogs in which associated middle ear disease was investigated and the palatine defects were surgical repaired. Radiographic abnormalities of the tympanic bullae were seen in both ears of all six dogs (12 of 12). Negative tympanocentesis findings were recorded in 11 of 12 ears. A purulent otitis media was confirmed in one ear of one dog, and loss of hearing was also demonstrated in this ear on brainstem auditory evoked response hearing assessment. There was no evidence of hearing loss on brainstem auditory evoked response in any of the remaining ears. Surgical repair of the soft palate defect was undertaken in all six dogs. Long-term assessment of the clinical outcome was considered excellent in five dogs and reasonable in one dog (mean 18 months, range seven to 27 months). It would appear that surgical intervention for the treatment of bilateral palatine malformation/hypoplasia may be associated with a better prognosis than reported previously. The lack of middle ear effusion and associated hearing impairment suggests that the underlying aetiology of middle ear pathology in dogs suffering from congenital palatine defects may be different from that observed in human beings. The true nature of the radiographic bullae changes seen in dogs with soft palate defects remains unclear.     

Aneurysmal bone cyst in a rib of a cat

An aneurysmal bone cyst was identified in the rib of a 3 1/2-year-old domestic shorthair cat. Surgical excision of the cyst, with reconstruction of the thoracic wall, was performed. Though aneurysmal bone cyst is a benign neoplastic condition that may be associated with locally aggressive growth, it does not metastasize. The condition is rare in any species other than human beings, but has been reported in cats, dogs, and horses.