ABSTRACT
The clinical signs of middle ear disease are very similar to those of otitis externa and include local discomfort or even pain, and otic discharge, if the tympanum is ruptured (Fig. 6.1), or if there is associated otitis externa. Pain upon opening the mouth during eating, playing with a ball or stick or during yawning can sometimes be observed. Occasionally, neurological signs such as facial nerve paralysis and/or Horner’s syndrome may be seen (Fig. 6.2). In cats, the disease may not become apparent until the inner ear has been involved
Middle ear effusion as a result of infection, or auditory tube dysfunction, is the most commonly encountered abnormality of the middle ear in dogs and cats. Otitis media results from inflammation within the middle ear. The inflammation may arise de novo (primary otitis media) as is most commonly seen in cats, or as a consequence of otitis externa (most commonly seen in dogs), structural and functional abnormalities within the pharynx affecting the auditory tube function, or as a result of brachycephaly-related abnormalities (secondary otitis media). Otitis media is not uncommonly associated with polyp formation from middle ear or auditory tube mucosa in cats and has been discussed in Chapter 5 Aetiology and Pathogenesis of Otitis Externa, Section 5.9. Neoplastic disease originating
polyps need to be removed surgically, and concurrent otitis media should be treated with a course of systemic antibiotics (see Chapter 6 Diseases of the Middle Ear, Section 6.3). As cats get older the potential for otitis media and neoplasia increases8. The mean age of the cats in a study of 19 cats with otitis media subject to bulla osteotomy was as follows: • Inflammatory polyps, mean age 1.5 years. • Otitis media, mean age 5.5 years. • Middle ear neoplasia, mean age 10.25 years.
