Rigid normograde rhinoscopy-assisted traction-avulsion removal of small middle ear polyps from the auditory tube in five cats

Abstract

Case series summary: This study aims to describe a novel minimally invasive technique for the removal of small middle ear polyps from the auditory tube openings in cats. Five cats with clinical signs of otitis externa and/or otitis media, and/or upper respiratory tract inflammation were included. All cats underwent pharyngolaryngoscopy under anaesthesia, CT scan of the head, neck and thoracic cavity, video-otoscopic examination, retrograde nasopharyngoscopy and normograde rhinoscopy. The five cats described in this study were all found to have significant respiratory tract inflammation (rhinitis, sinusitis, nasopharyngitis, otitis media) with small polypous protrusions from the auditory tube openings. A normograde rhinoscopy-assisted traction-avulsion (RATA) removal of these small polyps was performed in all cases without complications. The rostral nasopharynx was visualised by a unilaterally normograde advanced rigid endoscope passing the choana, and polyps were removed using a grasping forceps introduced in the contralateral nostril. Telephone follow-up revealed clear improvement in all cases. One of the cases was re-evaluated with a CT scan and endoscopy 4 weeks after treatment. The CT scan showed a significant improvement with no abnormalities in both external ear canals and air opacity in both tympanic bullae. Video-endoscopic examination revealed intact tympanic membranes with mild chronic abnormalities and patent auditory tube openings upon normograde rhinoscopy. Relevance and novel information: Rigid normograde RATA is a novel, minimally invasive and effective technique for the removal of small middle ear polyps from auditory tube openings in cats with otitis media.