Canis ISSN: 2398-2942

Bulla osteotomy

Contributor(s): Jan Bellows, Andrew Gardiner, Daniel Smeak

Introduction

  • Surgical access to the tympanic bulla by means of a lateral or ventral osteotomy.
  • The middle ear is a pear-shaped cavity within the petrous temporal bone. The tympanic membrane, auditory ossicles, eustacian tube, and inner ear lie within the neck of this bone while the tympanic bulla is at its base.

Uses

  • Used in the treatment of otitis media Otitis media arising from inflammatory processes, and in neoplasia affecting the middle ear.
  • Exploration of the middle ear to determine cause of middle ear disease.

Advantages

  • Lateral osteotomy: conveniently performed at the same time as total ear canal ablation Ear: total ear canal ablation in many patients; intra-operative repositioning is not required.
  • Ventral osteotomy: offers maximal exposure of the tympanic cavity and both bullae are easily accessed without repositioning patient.

Disadvantages

  • Lateral osteotomy: does not provide as good access to the tympanic cavity as the ventral technique. Increased risk of facial nerve damage during the approach.
  • Ventral osteotomy: inconvenient when total ear canal ablation is being carried out, as patient repositioning is required.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good: if condition is not malignant. Complete evacuation of epilthelium, debris, foreign bodies is paramount to success of surgery. Consider ancillary therapies (radiation, chemotherapy) if neoplasia is found in middle ear.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Smeak D D, Crocker C B & Birchard S J (1996) Treatments of recurrent otitis media after total ear canal ablation and lateral bulla osteotomy in dogs - Nine cases (1986 - 1994) JAVMA 209 (5), 937-942 VetMedResource.
  • Smeak D D, Kerpsack S J (1993) Total ear canal ablation and lateral bulla osteotomy for management of end stage otitis externa. Semin Vet Med (1), 30 - 41 PubMed.
  • Beckman S L, Henry W B Jr. & Cechner P (1990) Total ear canal ablation combining bulla osteotomy and curettage in dogs with chronic otitis externa and media. JAVMA 196 (1), 84-90 PubMed.
  • Matthiesen D T & Scavelli T (1990) Total ear canal ablation and lateral bulla osteotomy in 38 dogs. JAAHA 26 (3), 257-67 VetMedResource.
  • Sharp N J H (1990) Chronic otitis externa and media treated by total ear canal ablation and ventral bulla osteotomy in 13 dogs. Vet Surg 19 (2), 162-6 PubMed.


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