Page 282 - Clinical Manual of Small Animal Endosurgery

270 Clinical Manual of Small Animal Endosurgery

(a)

(b)

Fig. 9.15 (a) Bacterial otitis media in a dog. (b) Otitis media caused by
yeast in a dog. In both cases there is rupture of the tympanic membrane.
Photographs courtesy of Dr G. Ghibaudo.

Frequently with severe middle- (and external-) ear disease the patient
may present with a tympanum that is already perforated. In these cases
the management is similar to that following a myringotomy. However,
culture results must be interpreted in light of the potential for contamina-
tion from the external ear. Again, copious irrigation should be under-
taken. It is worth noting that with appropriate medical management
following otoendoscopy the vast majority of ruptured tympanums will
heal well.
The clinician must be aware that for middle-ear disease that is refrac-
tory to therapy, or is associated with peripheral neurological signs, CT
and MRI are excellent adjunctive imaging modalities (Fig. 9.16).