Aural cholesteatoma in twenty dogs

posted in: CT Concepts | 0

Hardie EM, Linder KE, Pease AP.

Veterinary surgery : VS 2008;37:763-770.

OBJECTIVE: To determine the clinical course in dogs with aural cholesteatoma. STUDY DESIGN: Case series. ANIMALS: Dogs (n=20) with aural cholesteatoma. METHODS: Case review (1998-2007). RESULTS: Twenty dogs were identified. Clinical signs other than those of chronic otitis externa included head tilt (6 dogs), unilateral facial palsy (4), pain on opening or inability to open the mouth (4), and ataxia (3). Computed tomography (CT) was performed in 19 dogs, abnormalities included osteoproliferation (13 dogs), lysis of the bulla (12), expansion of the bulla (11), bone lysis in the squamous or petrosal portion of the temporal bone (4) and enlargement of associated lymph nodes (7). Nineteen dogs had total ear canal ablation-lateral bulla osteotomy or ventral bulla osteotomy with the intent to cure; 9 dogs had no further signs of middle ear disease whereas 10 had persistent or recurrent clinical signs. Risk factors for recurrence after surgery were inability to open the mouth or neurologic signs on admission and lysis of any portion of the temporal bone on CT imaging. Dogs admitted with neurologic signs or inability to open the mouth had a median survival of 16 months. CONCLUSIONS: Early surgical treatment of aural cholesteatoma may be curative. Recurrence after surgery is associated with advanced disease, typically indicated by inability to open the jaw, neurologic disease, or bone lysis on CT imaging. CLINICAL RELEVANCE: Presence of aural cholesteatoma may affect the prognosis for successful surgical treatment of middle ear disease.