Ear, nose and throat diseases of the dog and cat

521 Pages·2017·231.615 MB·English

by  Haar, Gert ter, Harvey, Richard G

Ear, Nose and Throat
Diseases of the
Dog and Cat
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Ear, Nose and Throat
Diseases of the
Dog and Cat
Richard G. Harvey BVSc DVD Dip ECVD FSB 
The Veterinary Centre, Cheylesmore
Coventry, UK
Gert ter Haar BVSc DVM, PhD, MRCVS, DECVS
President of the International Veterinary Ear Nose and Throat Association
Senior Lecturer Soft Tissue Surgery, Head of the ENT, Brachycephaly and
Audiology Clinics
Royal Veterinary College
Hatfield, UK

CONTENTS
v
ACKNOWLEDGEMENTS ix 2.9 Myringotomy 71
2.10 Neurological assessment of the pinna and
PREFACE xi external ear canal 72
2.11 Electrophysiological hearing tests 72
ABBREVIATIONS xii 2.12 References 79
PART 1 THE EAR 1 CHAPTER 3 EAR CLEANERS, EAR CLEANING,
CHAPTER 1 ANATOMY AND PHYSIOLOGY DEPILATORIES, CERUMINOLYTICS,
OF THE EAR 3 ANTIBIOTICS, TOPICAL STEROIDS AND
OTIC ANTIPARASITICS 85
1.1 Introduction 3
1.2 Gross and microscopic anatomy of the ear 3 3.1 Introduction 85
1.3 Microscopic structure of the external ear 3.2 Otic cleansers, ceruminolytics and
canal 18 depilatories 85
1.4 Microscopic structure of the tympanum and 3.3 Antimicrobial medications 88
middle ear 25 3.4 Topical antibacterial therapy 89
1.5 Microclimate of the external ear canal 27 3.5 Systemic antibacterial therapy 92
1.6 Effect of underlying disease and the effect 3.6 Systemic absorption of topical
of surgery on the otic environment and antibacterial agents and topical otic
microflora 30 glucocorticoids 93
1.7 Microbiology of the external ear canal 30 3.7 Antimalassezial treatment 93
1.8 Physiology of hearing 32 3.8 Methicillin-resistant staphylococci 94
1.9 References 35 3.9 Otic antiparasitic treatments 94
3.10 References 95
CHAPTER 2 DIAGNOSTIC PROCEDURES 43
CHAPTER 4 DISEASES OF THE PINNA 101
2.1 Introduction 43
2.2 History and signalment 45 4.1 Introduction 101
2.3 General otic and neurological examination 47 4.2 Pinnal trauma 101
2.4 Cleaning the external ear canal 47 4.3 Pinnal disease characterised by crust
2.5 Otoscopic appearance of the external ear and scale 102
canal and tympanum 49 4.4 Focal lesions principally affecting the
2.6 Cytological characteristics of normal and dorsal pinna 116
abnormal ears 55 4.5 Pinnal dermatoses causing papules and
2.7 Biopsy of the external ear canal 62 nodules 118
2.8 Imaging the external ear canal and the 4.6 Dermatoses principally affecting the
middle and inner ear 63 concave aspect of the pinna 121
vi
4.7 Dermatoses principally causing PART 2 THE NOSE 223
symmetrical pinnal alopecia 123 CHAPTER 8 NOSE ANATOMY AND
4.8 References 125 PHYSIOLOGY 225
CHAPTER 5 AETIOLOGY AND 8.1 Introduction 225
PATHOGENESIS OF OTITIS EXTERNA 131 8.2 Gross and microscopic anatomy of the nose 225
8.3 Regulation and conditioning of the airflow 231
5.1 Introduction 131 8.4 Mucosal cleaning, sneezing and reverse
5.2 The concept of primary and secondary sneezing 233
factors, predisposing factors and 8.5 Olfaction and vomeronasal organ function 234
perpetuating change 131 8.6 Microbiology of the normal nasal cavities
5.3 Primary causes of otitis externa 131 of dogs and cats 237
5.4 Secondary causes of otitis externa 150 8.7 References 238
5.5 Perpetuating factors 151
5.6 Practical management of otitis – putting CHAPTER 9 NOSE DIAGNOSTIC
theory into practice 153 PROCEDURES 243
5.7 Otitis externa in cats 169
5.8 Trauma to the ear canal 169 9.1 Introduction and approach to the diagnosis
5.9 Nasopharyngeal and middle ear polyps 172 of nasal disease 243
5.10 Para-aural abscessation 174 9.2 Functional and olfactory testing 244
5.11 References 176 9.3 The histopathology of the nasal planum 245
9.4 Radiographic features of the normal and
CHAPTER 6 DISEASES OF THE MIDDLE EAR 187 abnormal nose 246
9.5 Advanced imaging of the nasal cavity and
6.1 Introduction 187 nasal sinuses 250
6.2 Otitis media in the cat 188 9.6 Rhinoscopy and nasopharyngoscopy 253
6.3 Otitis media in the dog 189 9.7 References 256
6.4 Primary secretory otitis media/otitis
media with effusion 195 CHAPTER 10 DISEASES OF THE NASAL
6.5 Cholesteatoma 197 PLANUM 261
6.6 Trauma of the temporal bone 200
6.7 References 201 10.1 Introduction 261
10.2 Diseases affecting the rostral nose but not
CHAPTER 7 DISEASES OF THE INNER EAR 205 the nasal planum 263
10.3 Diseases affecting the nasal planum 268
7.1 Introduction 205 10.4 References 283
7.2 Congenital deafness 206
7.3 Congenital peripheral vestibular CHAPTER 11 DISEASES OF THE NASAL
syndromes 207 CAVITY AND SINUSES 289
7.4 Labyrinthitis 207
7.5 Ototoxicity 208 11.1 Introduction 289
7.6 Inner ear trauma 210 11.2 Congenital diseases of the nose 289
7.7 Age-related hearing loss 211 11.3 Brachycephalic obstructive airway syndrome 290
7.8 Noise-induced hearing loss 214 11.4 Epistaxis 294
7.9 Idiopathic peripheral vestibular ataxia 215 11.5 Nasal and nasopharyngeal foreign body 296
7.10 References 216 11.6 Mycotic rhinitis 297
Contents vii
11.7 Cleft palate and oronasal fistula 301 15.3 Pharyngeal mucoceles 371
11.8 Polyps and neoplastic disease 304 15.4 Pharyngitis and tonsillitis 373
11.9 Infectious rhinitis 306 15.5 Traumatic injuries of the pharynx 377
11.10 Allergic rhinitis 319 15.6 Pharyngeal and tonsillar neoplasia 380
11.11 Chronic, nonspecific or idiopathic rhinitis 320 15.7 Oropharyngeal dysphagia 384
11.12 Nasal and sinal trauma 321 15.8 References 386
11.13 References 322
CHAPTER 16 DISEASES OF THE LARYNX 395
CHAPTER 12 DISEASES OF THE
NASOPHARYNX 337 16.1 Introduction 395
16.2 Congenital abnormalities of the larynx 395
12.1 Introduction 337 16.3 Acute and chronic laryngitis 396
12.2 Nasopharyngeal stenosis and choanal 16.4 Laryngeal cysts, polyps and tumours 401
atresia 338 16.5 Laryngeal paralysis 403
12.3 Nasopharyngeal cysts and 16.6 Epiglottic entrapment and retroversion 405
craniopharyngioma 340 16.7 Traumatic injuries of the larynx 406
12.4 References 342 16.8 References 408
PART 3 THE THROAT 345 PART 4 SURGERY OF THE EAR, NOSE
CHAPTER 13 THROAT ANATOMY AND AND THROAT 415
PHYSIOLOGY 347 CHAPTER 17 PERIOPERATIVE
MANAGEMENT 417
13.1 Introduction 347
13.2 Gross and microscopic anatomy of 17.1 Introduction 417
the throat 347 17.2 Peri- and postoperative analgesia 417
13.3 Swallowing 353 17.3 Peri- and postoperative antibacterial therapy 419
13.4 Coughing and protection of lower airways 354 17.4 Postoperative nutritional management
13.5 Regulation of respiratory airflow and after ENT surgery 421
vocalisation 355 17.5 Postoperative dressings and wound
13.6 References 356 management 423
17.6 References 425
CHAPTER 14 THROAT DIAGNOSTIC
PROCEDURES 359 CHAPTER 18 SURGERY OF THE EAR 429
14.1 Introduction 359 18.1 Introduction 429
14.2 Throat inspection (pharyngolaryngoscopy) 360 18.2 Aural haematoma 430
14.3 Radiographic and ultrasonographic 18.3 Traumatic injury to the pinna and pinnal
evaluation of the throat 362 amputation 432
14.4 Videofluoroscopy 363 18.4 Lateral approach to the ear canal for polyp
14.5 Advanced imaging of the throat 365 removal 433
14.6 EMG of pharynx and larynx 366 18.5 Lateral wall resection 436
14.7 References 367 18.6 Vertical ear canal ablation 437
18.7 Total ear canal ablation 438
CHAPTER 15 DISEASES OF THE PHARYNX 371 18.8 Lateral bulla osteotomy 442
18.9 Ventral bulla osteotomy 442
15.1 Introduction 371 18.10 Ventilation tubes 445
15.2 Congenital abnormalities of the pharynx 371 18.11 References 447
viii
CHAPTER 19 SURGERY OF THE NOSE 451 CHAPTER 20 SURGERY OF THE THROAT 477
19.1 Introduction 451 20.1 Introduction and temporary tracheostomy 477
19.2 Biopsy and resection of the nasal planum 452 20.2 Surgical correction of oropharyngeal
19.3 Surgical correction of brachycephalic dysphagia 480
obstructive airway syndrome 455 20.3 Tonsillectomy 482
19.4 Closure of cleft palate and oronasal fistulae 457 20.4 Ventral neck exploration 483
19.5 Trephination of the nasal sinuses 462 20.5 Marsupialisation of mucoceles 484
19.6 Dorsal rhinotomy with turbinectomy 464 20.6 Arytenoid lateralisation for laryngeal
19.7 Ventral rhinotomy 466 paralysis 486
19.8 Lateral rhinotomy 467 20.7 Ventral laryngotomy for removal of
19.9 Nasopharyngotomy and nasopharyngeal laryngeal masses 486
polyp removal 469 20.8 References 489
19.10 References 471
INDEX 493
ACKNOWLEDGEMENTS
ix
The authors are indebted to colleagues who have pro- would also like to thank Drs Harari and DeLauche for
vided illustrations, in particular Dr David Duclos, their contributions. Other colleagues provided clinical
DVM, who put his entire picture bank at our disposal. pictures for us and these are credited in situ. We are
Professors Sue Dawson, BVMS PhD MRCVS and most grateful to all of these colleagues, who have all
Lynette Cole, DVM, MS, DACVD, and Drs Louis helped us to create this book.
Gotthelf DVM and Marge Scherk DVM, DABVP It goes without saying that our families suffered as we
(Feline Practice) provided most valuable advice. Dr searched databases, begged illustrations and wrote text.
Richard Lam, DECVI, provided excellent quality diag- To them, a special thanks.
nostic imaging figures. We also owe thanks to Dr. Alex
Stoll for his microscopic artwork and Joop Fama for Richard Harvey
his fantastic intraoperative photographs. The authors Gert Ter Haar