Aural Haematoma

Re: Aural Haematoma

Anthony Todd — Tue, 20 Jan 2015 17:55:53 GMT

There's another similar thread just started so hopefully it'll end up in one.

Re: Aural Haematoma

Anthony Todd — Thu, 29 Nov 2012 23:30:38 GMT

[quote user="Michael Woodhouse"]It's not like we are operating on people where the cosmetics matter.[/quote]

True, in a spaniel it probably doesn't matter but it's nice to get the cat's ear back to normal and, if the canal is occluded by a crumpled ear they tend to get otitis again.

Have done some in spaniels using the flat side remaining from the plastic container,after the corner splints for a cat.....

Re: Aural Haematoma

Michael Woodhouse — Thu, 29 Nov 2012 23:17:39 GMT

[quote user="Anthony Todd"]Oh, I suppose you ride a bike....[/quote]

Don't you start insulting my wife!

I'm really not fussed if the dog has a bit of a scar on its ear. I'd say almost all I do are spaniels. I'd say rare in erect eared dogs, and think I have only ever seen 1 in a cat and that was crawling in ear mites.

It's not like we are operating on people where the cosmetics matter.

Re: Aural Haematoma

Anthony Todd — Thu, 29 Nov 2012 23:11:44 GMT

[quote user="Michael Woodhouse"]It's just a pet.[/quote]

You're winding me up, surely?

And it's not the weekend.

And the F1 season's over.

Oh, I suppose you ride a bike....

Re: Aural Haematoma

Michael Woodhouse — Thu, 29 Nov 2012 22:54:53 GMT

[quote user="Anthony Todd"]Cats, particularly, show gross distortion and the longer the medial [or inside] incision, for "drainage", the more distortion there is.[/quote]

So?

It's just a pet.

Re: Aural Haematoma

Anthony Todd — Thu, 29 Nov 2012 22:48:06 GMT

[quote user="Malcolm Ness"]Nonsense.[/quote]

Absolutely not my experience, ever, but please provide comparative full frontal photos of the post -surgical and unaffected pinna after buttons or a penrose drain.

Happy to accept your opinion if, from the photos, it is difficult to decide which ear had the haematoma.

Cats, particularly, show gross distortion and the longer the medial [or inside] incision, for "drainage", the more distortion there is.

Re: Aural Haematoma

Matt Hilary — Thu, 29 Nov 2012 14:58:38 GMT

I've had a couple where they do genuinely appear to be spontaneous - i.e. no history of otitis, no head-shaking/scratching in evidence, nothing on otoscopy. Doesn't rule out trauma though.

Re: Aural Haematoma

James Laidlaw — Thu, 29 Nov 2012 12:01:47 GMT

[quote user="Michael Woodhouse"]

[quote user="James Laidlaw"]Aural harm atoms are almost always a secondary problem and controlling the primary skin issue should help fix the ongoing ear problems, [/quote]

That was always my thoughts until the last long thread. Seems that it's not blood in there and haematoma is misleading. I always assumed head shaking = capillary rupture.

Not sure it was even mentioned at college.

[/quote]

If not blood then I'd assume they are old and the clot/fluid has settled. What else is going to cause them if not a haematoma?

Re: Aural Haematoma

Malcolm Ness — Thu, 29 Nov 2012 10:33:36 GMT

[quote user="Anthony Todd"]

is an inevitable consequence of buttons or penrose drains in any event.

[/quote]

Nonsense.

Re: Aural Haematoma

Anthony Todd — Thu, 29 Nov 2012 09:19:59 GMT

[quote user="Busybee"]

Was going to say, how long did you leave the sutures in for. Keeping the sutures/drip tubing/buttons in for 3-4 weeks seems to be key!

[/quote]

I would suggest 5-6 weeks if you want no distortion of the pinna which, as I repeatedly reiterate, is an inevitable consequence of buttons or penrose drains in any event.

Re: Aural Haematoma

Simon Neuhoff — Thu, 29 Nov 2012 09:11:28 GMT

Following the prev thread I have also adopted the penrose drain technique - only had two occasions to use it to date but find it very quick, very effective. Messy initially but the clients are forewarned and cope with it well.

I was always taught that aural haematomas were the result of trauma. Again following the previous thread I've started looking at these cases again and the most recent one had no obvious otitis at all.

Given how common otitis externa is it would be curious to know if there is in fact a link between it and aural haematomas or is it simply coincidence?

Re: Aural Haematoma

Michael Woodhouse — Wed, 28 Nov 2012 23:42:44 GMT

[quote user="James Laidlaw"]Aural harm atoms are almost always a secondary problem and controlling the primary skin issue should help fix the ongoing ear problems, [/quote]

That was always my thoughts until the last long thread. Seems that it's not blood in there and haematoma is misleading. I always assumed head shaking = capillary rupture.

Not sure it was even mentioned at college.

Re: Aural Haematoma

Anthony Todd — Wed, 28 Nov 2012 23:15:28 GMT

[quote user="mariette asselbergs"]Since learning from the last thread I have tried the penrose mdrain on a number of cases and all great with very little hassle, [/quote]

Still waiting for those full frontal pictures of prick ears, dogs or cats, showing no difference between the pinnae; something possible only with the plastic splint method as previously discussed.

And that method hardly drips at all either.

Re: Aural Haematoma

mariette asselbergs — Wed, 28 Nov 2012 18:41:56 GMT

Since learning from the last thread I have tried the penrose mdrain on a number of cases and all great with very little hassle, can definitely recommend it! Only thing is that they leak for a number of days, so owner needs to be prepared for that, not let the dog on a new white fluffy arpet or the sofa etc!

Mariette

Re: Aural Haematoma

Busybee — Wed, 28 Nov 2012 17:35:39 GMT

Was going to say, how long did you leave the sutures in for. Keeping the sutures/drip tubing/buttons in for 3-4 weeks seems to be key!

Re: Aural Haematoma

Martin Atkinson — Wed, 28 Nov 2012 16:49:28 GMT

[quote user="Tracy Arend"]He had surgical treatment on his right ear at another practice, which seemed to be helping keep the haematoma at bay, but kept getting recurring haematomas with the left ear. We then decided to surgically correct the haematoma in the left ear. He was doing well post operatively, managed to keep his ear bandage on and was on a higher dose of pred to keep the head shaking at bay. Within 2 days of suture removal, the haematoma refilled.

[/quote] What method did you use and what did they use. I've found after many different methods that sewing it flat with plastic buttons either side for 3 weeks and no bandaging does the trick with minimal post-op complications - not had one recur yet after that.

Re: Aural Haematoma

Robin Grimmer — Wed, 28 Nov 2012 14:27:59 GMT

[quote user="James Laidlaw"]I'd think the key focus should be on the skin disease/puritis and shaking/scratching. Aural harm atoms are almost always a secondary problem and controlling the primary skin issue should help fix the ongoing ear problems, regardless of technique used.

[/quote]

I agree in some cases aural haematomas can be secondary to skin/ear disease. However in many cases (especially labradors, retrievers and sheepdog breeds) they seem to be spontaneous.

Re: Aural Haematoma

James Laidlaw — Wed, 28 Nov 2012 13:48:48 GMT

I'd think the key focus should be on the skin disease/puritis and shaking/scratching. Aural haematomas are almost always a secondary problem and controlling the primary skin issue should help fix the ongoing ear problems, regardless of technique used.

Re: Aural Haematoma

Anthony Dennison — Wed, 28 Nov 2012 12:39:02 GMT

Penrose drain procedure is fantastic, can even be done under deep sedation in some dogs! We send them home on 2mg/kg steroids for 1wk, have a post-op check and remove the drain then continue for a further week on 1mg/kg before weaning off.

Re: Aural Haematoma

KMurphy — Wed, 28 Nov 2012 12:26:16 GMT

Love, love, love the penrose drain procedure. Has changed aural haematomas from one of my least favourite ops into something that can just be slotted in any given day, no matter what my mood :)

Re: Aural Haematoma

Jo Cobbett — Wed, 28 Nov 2012 12:17:57 GMT

Have a look at this previous thread:

http://www.vetsurgeon.org/forums/p/10504/53683.aspx#53683

I would generally do exactly what you've done so far, so can't offer much more, but there was a procedure involving a penrose drain on the previous thread that looked promising and that I keep meaning to try...