Diagnosing otitis media/interna can be accomplished with physical exam findings. Sometimes, sedation or anesthesia may be required to fully examine the ear if the pet is too painful.
Since most middle/inner ear infections are progressions of an external ear infection, extensive flushing and cleaning of the external ear canal is frequently necessary before exam of the middle ear.
Some polyps can be diagnosed based on examination. The polyp may begin in the middle ear, push through the eardrum and be visualized in the external ear canal.
If the eardrum is bulging, it may need to be punctured or perforated in order to collect and analyze fluid within the middle ear. This procedure is referred to as a myringotomy and is performed under anesthesia.
The fluid within the middle ear is collected and analyzed. Culture of the fluid may reveal bacteria. Cytology (microscopic exam of the fluid and discharge) may reveal fungi, yeast, parasite or cancer cells.
Once the cause of the otitis media/interna has been determined, treatment can begin and includes: If the eardrum is not ruptured, it will need to be punctured to alleviate pain and pressure and allow for drainage of any built up fluid. Once the eardrum is perforated, the middle ear is flushed. After this procedure, about 50% of patient's eardrum heal.
Oral antibiotics are typically administered for 3-6 weeks.
Ear medications are only used if absolutely necessary. Using ear medication without an intact eardrum can result in permanent deafness or signs of an inner ear infection (dizziness, head tilt, vomiting).
If no improvement, surgery is the next option. There are various surgical procedures performed to treat middle and inner ear infections. The severity of the infection will determine which procedure is chosen.
Lateral Ear Resection
This procedure is done if the primary problem in an external ear canal that does not adequately dry. Chronic external ear infections can lead to middle ear infections. By removing a portion of the external ear canal, the remaining canal is wider and easier to dry. This can reduce external ear canal infections and therefore, reduce middle ear infections. The patient typically does not lose hearing as a result of this procedure. (The patient may have already become deaf from chronic infections)
Lateral Bulla Osteotomy
This procedure involves entering the middle ear through an incision on the side of the ear base and penetrating into the bone surrounding the middle ear. Once the middle ear cavity is entered, it is flushed and a drain is placed until the infection is under control. Some animals may still be able to hear following this procedure.
Total Ear Canal Ablation
This is the most severe surgery where the entire ear canal is removed. This is a salvage procedure and done when no other treatment is effective. Following this procedure, the patient is deaf.
After treatment, periodic exams are necessary to reduce the risk of future infections and to make sure the current infection is responding to treatment. Make sure your pet's ear canals are kept clean and dry.