Module 2- Ear Examinations & Routine Tests

List three anatomical variations of the ear

1. Pinna

2. Hair

3. Canals

What are the anatomical variations of the pinna? (2 basic)

• 2 basic= erect or pendulous

What are the anatomical variations of erect ears?

• natural or cropped

• large or small

• folding at tip or straight

What are the downsides to heavy, pendulous ears?

Little air circulation resulting in warm, moist environment

Supports growth of bacteria, fungi and yeast

What breeds have heavy, pendulous ears?

Spaniels and hounds

What are the downsides of excess hair in pinna/vertical ear canal?

• Poor ventilation and natural cleaning of the ear

What are the downsides of a narrowed/ elongated ear canal?

• poor ventilation= bacteria breeding ground

List the steps of an ear PE

1. Behavior

2. External Ear/Pinna

3. Ear Cartilage Canals

4. Otoscopic Exam

List 2 predisposing factors for ear problems in dogs

• Dogs that spend a lot of time in the bush/water

• dogs with skin disease

List behavior signs that indicate physical ear problems

• head tilt

• scratching or pawing the ear

• rubbing ear on floor

• head shaking

List the behavioral signs that indicate hearing problems (3)

• fail to look towards the sound when you enter the room

• usually apprehensive when you are out of sight

• fails to response to a noise- animal should startle when you clap your hands behind it

List abnormal signs to look for in external ear/pinna (3)

• loss of hair/skin trauma

• odors- foul or sweet

• pain on palpation

What to look for when examining ear cartilage and canals (5)

• dirt and debris

• discharge- purulent, bloody, serous “yeasty” or black

• Redness/ swelling within the pinna

• Aural hematoma

• Foreign Body

List the steps of an otoscopic exam

1. place clean/ appropriately sized speculum or cone on the otoscope

2. Examine healthy ear first

3. DO NOT TRANSFER DISEASE FROM ONE EAR TO THE OTHER

Steps of an Otoscopic exam (6)

1. Use effective restraint

2. Grasp pinna with “off’ hand

3. Visualize vertical canal- then introduce speculum. (Direct speculum gently along canal in downward direction while applying slight traction on the pinna

4. Visualize canal through otoscope (look for foreign bodies, parasites, lumps, lesions, inflammation)

5. At junction of vertical and horizontal canals, slowly return speculum to horizontal position while continuing dorsal-lateral traction on pinna

6. The tympanic membrane, is usually visible at the end of the horizontal canal. (Appears pearly white, translucent structure, pale in center and darker pink at the margin)

Otitis externa

Inflammation of external ear (pinna to tympanic membrane)

Otitis media

Inflammation of middle ear (Tympanic membrane to Eustachian tube)

Otitis interna

Inflammation of inner ear (cochlea and semicircular canals)

What can cause otitis? (5)

• bacteria

• Parasites

• Yeast

• Foreign bodies

• Aural hematoma

Aural Hematoma

Hematoma within the layers of the pinna caused by vigorous head shaking (cauliflower ears)

How to do an ear swab? *always do before cleaning

• 2 dry clean swabs in each ear (1 to roll on slide for microscopic analysis, 1 to send for culture)

• Grasp pinna to expose cartilage folds

• Insert swab into vertical canal & roll to obtain sample of exudate

• Repeat on other ear

List four complications of ear cleaning

• contamination by transfer

• rupture of eardrum

• trauma to tissue

• Excessive drying of tissue with overuse

Complications of ear flushing

rupture of tympanic membrane

trauma to tissue- aggressive flushing, irritation from product used etc

What are more clinics doing when flushing ear to prevent tympanic membrane ruptures

• using video otoscope to guide under general anesthesia

what is TECA stand for/what is the procedure?

-Total Ear Canal Ablation-

• removal of vertical ear canal to tympanic membrane

Why would a TECA be done?

• if patient has chronic ear problems due to infections or polyps (external otitis)

What’s the purpose of “plucking the ear”?

Remove excess hair growing in vertical canal

What is one complication to plucking the ear?

What are the 3 steps to plucking the ear?

Complication: trauma to canal by accidentally grasping tissue with forceps rather than hair

3 steps:

• use small haemostat or fingers

• Grasp hairs, twist until they pull out

• Repeat until hair removed

What cleaners should not be introduced to the ear when the tympanic membrane is ruptured?

• cleansers

• Parasiticides

• Disinfectants

• Cerumenolytics

• Oil-based meds

What are the steps for a simple cleaning? (7)

• clip excess hair from underside of pinna

• I still 8-10 drops of cleanser

• Massage base of ear SQUISHING SOUNDS SHOULD BE HEARD

• Allow animal to shake it

• Use cotton, sponges, or tissue to remove debris (never use q tips)

• Repeat weekly if necessary

What are the steps of flushing an ear and in what case would you do this?

Otitis external

• Make solution warm (dilute hibatane)

• Restrain dog, get towels

• Fill syringe with solution

• Insert tip into vertical canal and gently and squirt contents of syringe

• Massage ear base

• Flush ear with water

• Dry ear

• Look in ear w otoscope

1. Auditory ossicles

2. Semicircular canals

3. Utricle

4. Tympanic membrane

5. External auditory

6. External auditory canal

7. Perilymph

8. Pinnacle

9. Vestibulocochlear nerve

10. Saccule

11. Cochlea containing endolymph

12. Eustachian tube

13. Round window of cochlea

14. Oval window of cochlea