Polyps in cats' ears.

Re: Polyps in cats' ears.

Andrew Mellor — Mon, 18 Oct 2010 10:41:18 GMT

I seem to see a lot of these , best to debulk either by pulling off through a otoscope or by lateral wall resection. But I have to say invariably they originate at vertical/horizontal canal junction or horizontal canal so you do a lot of lovely delicate surgery and don't remove the offending part of the canal. My prefered option is a teca or lateral wall but seems to always be the people with no money that these occur in. I offer the above but often plump for a really quick surgery to get to the horizontal canal and give you better access in the future when they grow back. split the vertical canal stight down lateral wall from the intertragic incisure to the horizontal junction , then simple continuous closure from one side to the other with fine absorbable suture 4/0 vicryl something like that, then you can clean and remove polyp etc, ear drops afterwards with steroid in reduced growth of polyp.

It will bleed a bit but can be done in 5-10 mins tops and is a salvage procedure after all.

Care do not cauterise the polyp base as if you are too thorough and leave cartilage exposed it either never heals or takes forever.

Re: Polyps in cats' ears.

Jillian Hall — Sun, 17 Oct 2010 00:36:09 GMT

I've had few older cats with external ear masses at the RSPCA. They have caused nasty otitis ext which has ended up refractory to medical tx. I've treated 2 with TECAs and they've done very well. I justifed the more agressive surgery on the basis of a lower chance of recurrence and therefore a better chance of rehoming. Rightly or wrongly. Initially if it was an owned cat I'd probably have done the lateral wall resection first, altho now, having seen how well the TECAs have done I might be more inclined to plump for this in the future.

Re: Polyps in cats' ears.

Evelyn Barbour-Hill — Sat, 16 Oct 2010 17:26:52 GMT

Well, it would be perfectly acceptable from what you describe to go on treating medically as an otitis externa for quite some time. But surgery would be better. I can't say what the prognosis would be, without seeing exactly where the lump is and what it is, but I would just say that cats do extremely well with lateral wall resection.

Re: Polyps in cats' ears.

Laura Atkinson — Sat, 16 Oct 2010 15:48:27 GMT

Sorry for the confusion, it's a nodular tumour that has arisen from the lining of the ear canal.

Re: Polyps in cats' ears.

Richard Fox — Thu, 14 Oct 2010 12:11:56 GMT

Yup Bob +1 - Poss a ceruminous gland tumour or a nasopharyngeal polyp would be most likely although if chronic inflammation has been present a hyperplastic polyp is also possible but more so in a dog with hyperplastic otitis externa. Biopsy to be sure? Here is a histo picture of a feline nasopharyngeal polyp if anyone is interested :)

Re: Polyps in cats' ears.

bob lehner — Wed, 13 Oct 2010 10:45:04 GMT

[quote user="Evelyn Barbour-Hill"]

P.S.

Is it definitely a polyp and not an adenoma?

[/quote]

Indeed - possibly some confusion over terminology/origin.

Are we talking about a naso-pharangeal type polyp, originating in the middle ear, that has popped through into the external ear canal, or a nodular tumour (adenoma/ceruminoma) arising from the lining of the external ear canal itself. These latter ones can get quite big and block the ear canal. They sometimes have a narrow stalk and people therefore call them aural/ear polyps.

Re: Polyps in cats' ears.

Rob Loxley — Tue, 12 Oct 2010 21:12:44 GMT

I was under the impression that VBO was the standard approach for feline middle ear polyps?

Re: Polyps in cats' ears.

Evelyn Barbour-Hill — Tue, 12 Oct 2010 15:54:20 GMT

P.S.

Is it definitely a polyp and not an adenoma?

Re: Polyps in cats' ears.

Evelyn Barbour-Hill — Tue, 12 Oct 2010 15:52:05 GMT

Poking down a speculum usually just mashes the thing even if you pull out some bits.

They originate in the middle ear. You need a lateral wall resection and then you can snare or scoop the thing out, or rather a satisfactory mass of it. It's quite likely to regrow, though not that soon, but then you have easy access because of the previous lateral wall resection. I don't think a bulla osteotomy is necessary unless there is a purulent otitis media.

Don't forget to have a look in the nasopharynx too . Hook the soft palate forward and if you see a mass it's fairly easy to grasp and pull. Often it comes away with a nice sucking sensation and you find there's quite a stalk on it from the Eustachian tube.

There is no cheap option.

Re: Polyps in cats' ears.

Martin Atkinson — Tue, 12 Oct 2010 14:52:02 GMT

You can often pull/nibble these polyps out with a satisfying degree of success or at least debulk them with a pair of fine crocodile forceps through an otoscope speculum and then get some medication and air circulating below them which buys you some time. Unfortunately a high proportion are also in the middle ear not to mention the naso-pharynx and a bulla osteotomy or pharyngeal surgery is also needed to prevent re-growth but even then they often recurr. I've not found a lateral wall resection to be of great benefit if they won't come out with the forceps but someone may be along soon with a different experience. As the root cause is usually chronic flu virus infection, antiviral treatement and steroids may help recurrence but could they afford it?