Myringotomy in dogs: Contamination rate from the external ear canal - a pilot study

Reinbacher, Elisabeth; Kneissl, Sibylle; Hirt, Reinhard; Spergser, J.; Panakova, Lucia

doi:10.1016/j.vas.2020.100125

Cited by 10 publications

(17 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In around one fifth of affected ears in this study, concurrent Malassezia OM was diagnosed based upon otoscopic findings and sampling of middle ear content. This procedure carries the potential for iatrogenic contamination of yeast from the ear canal into the tympanic cavity and thereupon false diagnosis of Mal OE/OM 33,34 . The frequency of Mal OE/OM in the present study, however, is comparable to reports of OM diagnosed in dogs with undefined, chronic OE using CT 35 and MRI 17 imaging.…”

Section: Discussionsupporting

confidence: 44%

Malassezia otitis unresponsive to primary care: outcome in 59 dogs

Boone

Bond

Loeffler

et al. 2021

Veterinary Dermatology

View full text Add to dashboard Cite

Background Otitis externa (OE) is a common disorder in dogs. Infection by the commensal yeast, Malassezia pachydermatis, may result in chronic disease that does not respond to standard primary care. Chronic infectious OE may be associated with otitis media (OM). Hypothesis/Objective To report medical management, clinical outcomes and frequency of middle ear involvement, in dogs with Malassezia otitis unresponsive to primary care. Animals Fifty‐nine dogs from one referral veterinary hospital from January 2007 to September 2018. Methods and materials Retrospective analysis of medical records of dogs referred with chronic otitis and treated for Malassezia otitis at a referral veterinary hospital. Results Chronic Malassezia OE was treated successfully in 91% of ears, in 87% of these cases with one ear flush intervention. Median time‐to‐resolution was 27 days after ear flush intervention. Neither duration of otitis, presence of neutrophils in aural discharge nor administration of oral itraconazole affected clinical outcome. Malassezia OM occurred concurrently in 17% of ears. Conclusions and clinical relevance These findings assist clinicians and carers of affected dogs in decision‐making, by documenting that most cases of canine Malassezia otitis that have not resolved with standard primary care, can be treated successfully with a well‐staged and intense medical treatment plan. Malassezia OM should be suspected to occur concurrently in around a fifth of affected ears.

show abstract

Section: Discussionsupporting

confidence: 44%

Malassezia otitis unresponsive to primary care: outcome in 59 dogs

Boone

Bond

Loeffler

et al. 2021

Veterinary Dermatology

View full text Add to dashboard Cite

show abstract

“…In a study of normal canine cadavers, contamination with fluorescein‐stained saline from the horizontal canal was noted in 19 of 28 (68%) of the middle ears. There was positive bacterial growth in only one of 11 (9%) of the middle ears with corresponding external ears with positive cultures 10 . However, microbial contamination may have been rare in this study as these were normal ear canals that were first cultured, and then flushed and suctioned before myringotomy.…”

Section: Myringotomy Proceduresmentioning

confidence: 75%

“…There was positive bacterial growth in only one of 11 (9%) of the middle ears with corresponding external ears with positive cultures. 10 However, microbial contamination may have been rare in this study as these were normal ear canals that were first cultured, and then flushed and suctioned before myringotomy. If these ears had been infected, the microbial contamination rate may have been higher.…”

Section: Myringotomy Proceduresmentioning

confidence: 94%

Clinical Techniques: When and how to do a myringotomy – a practical guide

Cole

Nuttall

2021

Veterinary Dermatology

View full text Add to dashboard Cite

A myringotomy is a surgical incision made in the tympanic membrane (TM). This gives access to the middle ear for sampling, flushing and instilling topical therapy. It should be considered whenever the TM is intact and there is clinical evidence of otitis media, abnormal TMs and/or abnormal diagnostic imaging. Samples should be collected for cytological investigation and culture, and then the external ear should be cleaned and dried (if required). Myringotomies should be performed under general anaesthesia and, wherever possible, using a video otoscope; the enhanced view and instrument ports facilitate the technique and reduce the risk of complications. The myringotomy incision should be made in the caudoventral quadrant of the TM using an appropriately sized urinary catheter to collect samples and flush the middle ear cavity. A thorough understanding of the anatomy, technique and potential ototoxicity of topical therapy is needed to minimize the risk of neurological and other complications. The TM usually heals within 35 days if kept free of infection.

show abstract

“…The high contamination rate (67%) of MEC samples with material from EEC reported in a previous study by Reinbacher et al. (2020) using the traditional myringotomy technique might highlight the value of this novel technique in order to avoid MEC contamination.…”

Section: Discussionmentioning

confidence: 88%

“…It may lead to pressure reduction of the MEC, specimen collection for cytology and microbial cultures, and administration of drugs into the MEC ( Bruyette & Lorenz, 1993 ; Rose, 1977 ). In a previous study by Reinbacher, Kneissl, Hirt, Spergser and Panakova (2020) on canine cadavers free from otitis, specimens from the MEC sampled via video-otoscopically controlled myringotomy were contaminated with material from EEC in over 67% of cases. In this study, contamination of MEC aspirates was confirmed by the presence of fluorescent dye introduced into the EEC before aspiration.…”

Section: Introductionmentioning

confidence: 97%

A novel video-endoscope-guided myringotomy technique in dogs: Investigation in the value of vertical access to the tympanic membrane from beneath the patient - a pilot study

Mohammaddavoodi

Kneissl

Hirt

et al. 2021

Veterinary and Animal Science

Self Cite

View full text Add to dashboard Cite

Myringotomy is a well-accepted method for diagnosing and treating otitis media in dogs having an intact tympanic membrane. In a recent study, the contamination rate of middle ear aspirates from the external ear canal via myringotomy was 67%. To evaluate the iatrogenic contamination rate of the middle ear aspirates by material from the ear canal, using a novel technique: Vertical access to the tympanic membrane from beneath the patient. Thirty-six ears from 20 canine Fresh cadavers with a CT scan negative for otitis externa and otitis media were video-otoscopically flushed with the ear upside. The instillation of the fluorescent dye into the ear canal and immediate retrieval were performed. With the patient positioned on a custom-made fenestrated table plate, a modified video-otoscopically guided myringotomy approaching the tympanum vertically from underneath, was performed. Contamination rates were assessed by the visual detection of fluorescent dye within the aspirated fluid, either by yellow staining solely, or a positive fluorescence test. Cytology and microbial cultivation were accomplished. Middle ear sample contamination by the material from the ear canal was identified in 2 of 36 (5.55%) ears. Neither a change in colour nor fluorescence was detected in 34 of 36 (94.44%) middle ear samples. Sixteen of 36 (44.44%) external ear canal samples and 4 of 36 (11.11%) middle ear aspirates had positive bacterial culture. This novel technique is a promising method for middle ear material collection in patients with concurrent otitis externa.

show abstract

Myringotomy in dogs: Contamination rate from the external ear canal - a pilot study

Abstract: Highlights Sample collection via myringotomy is associated with a high contamination rate. The suitability of this method for detection of otitis media is questionable. Iatrogenic spread of pathogenic microorganisms into the middle ear is possible.

Cited by 10 publications

References 32 publications

Malassezia otitis unresponsive to primary care: outcome in 59 dogs

Malassezia otitis unresponsive to primary care: outcome in 59 dogs

Clinical Techniques: When and how to do a myringotomy – a practical guide

A novel video-endoscope-guided myringotomy technique in dogs: Investigation in the value of vertical access to the tympanic membrane from beneath the patient - a pilot study

Contact Info

Product

Resources

About