Conclusion: Aural polyp with preservation of pneumatisation of mastoid air cells points towards diagnosis other than COM.Ĭhronic Otitis Media (COM) with or without cholesteatoma may be associated with the formation of an aural polyp which is usually confined to middle ear and external auditory canal (EAC) but may sometimes protrude outside the EAC.
It was observed that though HRCT temporal bone is a commonly advised investigation in patients of chronic otitis media (COM) with aural polyp, meticulous interpretation may reveal unusual features pointing towards sinister diagnosis. Further, there was only partial loss of pneumatisation of the mastoid air cells in all of the 3 cases. Features noted were: widening of the jugular foramen (meningioma), destruction of the anterior wall of mesotympanum (neurilemmoma), enhancing soft tissue density lesion (capillary hemangioma). Review of the preoperative High Resolution Computed Tomography (HRCT) temporal bone revealed an unusual picture in all of the three cases. However, histopathological diagnosis in 3 of these patients was unusual and rare benign tumors of the middle ear cleft-meningioma, neurilemmoma and capillary hemangioma. Histopathological examination revealed cholesteatoma in 22 (88%) patients. If you have an interesting case that you would like to submit with pictures, please contact Dr.Twenty five patients of aural polyp who underwent canal wall down mastoidectomy were analysed retrospectively. Topical high dose steroids and antibiotics may be used as well. A ventral bulla osteotomy for removal of aural polyps has a much lower recurrence rate than the traction and avulsion technique.Īfter removal, oral antibiotics should also be given based on bulla cultures, and oral anti-inflammatory doses of steroids should be given for several weeks to reduce the incidence of re-growth. Curved forceps are inserted into the ear canal, and the mass is grasped and extracted with traction. Polyps that are more fibrous or difficult to reach may require a ventral bulla osteotomy for removal. The stalk of the polyp should be removed as well.
Aural polyp full#
This radiograph was copied using the OtoPet-USA Video VetScope full image lens.Īural polyps may be removed by steady traction and twisting of the polyp with forceps while that cat is under anesthesia and while using videoscopy. To the left is a radiograph of a bulla showing some opacity that is consistent with a polyp in the right middle ear. If a polyp is suspected in the middle ear, then open-mouth skull radiographs may be taken and can show increased density within one of the bulla and in the horizontal ear canal. The tympanic membrane may appear discolored or distorted if the polyp is located in the middle ear. They may also appear red or white, or be covered in blood or mucous. Upon examination of the ear canal using an otoscope, an aural polyp appears as a smooth, pink mass. Polyps are benign, fleshy masses that may be found in the nose, nasopharynx, middle ear, and/or external ear canal. They may also be found in a non-clinical cat’s routine exam using an otoscope. This cat was sent home on topical steroids to help prevent re-growth, and oral antibiotics – as secondary bacterial infections are commonly associated with aural polyps.Īural polyps may be found in a cat’s ear when they have clinical signs that include head shaking, pawing or scratching at the ear, nystagmus, head tilt, otic exudate, ataxia and Horner’s syndrome. Once visualized, forceps were used with video guidance to grasp and extract the polyp using the traction and avulsion method, which will be discussed below. The cat was placed under general anesthesia and the polyp was again visualized using the OtoPet-USA Video VetScope. The OtoPet-USA Video VetScope was used to perform an otoscopic exam and this picture of the cat’s aural polyp was taken and documented for records.
A cat presented for pawing and scratching at his ear for several weeks duration.
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