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Clinical analysis and nonsurgical management of 11 dogs with aural cholesteatoma
Author(s) -
Imai Akihiro,
Kondo Hirotaka,
Suganuma Tsunenori,
Nagata Masahiko
Publication year - 2019
Publication title -
veterinary dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.744
H-Index - 60
eISSN - 1365-3164
pISSN - 0959-4493
DOI - 10.1111/vde.12707
Subject(s) - medicine , cholesteatoma , middle ear , ear canal , bulla (seal) , otitis , surgery , facial canal , magnetic resonance imaging , myringotomy , radiology , lung
Background Aural cholesteatomas, also called tympanokeratomas, are destructive and expansile growths of keratinizing epithelium that develop in the middle ear. They have been reported sporadically in dogs, and surgery is usually the recommended treatment. Objectives To describe the common clinical, radiological and histological findings of cholesteatoma; to report on the outcome of conservative management. Animals Eleven dogs (13 ears) with cholesteatomas. Methods and materials Medical records were reviewed for dogs diagnosed with cholesteatoma between 2012 and 2018. All dogs had computed tomography ( CT ) and/or magnetic resonance imaging ( MRI ) followed by trans‐canal endoscopic procedure ( TEP ) for removal and biopsy of middle ear lesions. Dogs were then treated with in‐clinic flushing initially weekly tapered to monthly, as well as at‐home ear cleaning and application of topical otic steroid medication, initially daily then tapered to once or twice weekly. Results Nine dogs had a history of chronic otitis externa; head tilt or facial paralysis was present in seven and four cases, respectively. Otic examination identified a protruding nodule in seven ears. CT demonstrated soft tissue‐like material in 12 bullae and expansion in seven bullae. MRI revealed minimally contrast‐enhancing bulla contents in 12 ears. Post‐ TEP and with maintenance medical treatment, nine ears had no further signs of middle ear disease during a mean follow‐up of 27.9 months. Conclusions and clinical importance The results suggest that otitis externa may not necessarily precede cholesteatoma in all dogs. MRI appears to be more sensitive than CT for identifying cholesteatomas. Conservative treatment of cholesteatomas could be useful before or as an alternative to surgery.