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经内镜经鼓膜牵引术治疗猫耳炎性息肉:37例猫病例回顾

Per-endoscopic trans-tympanic traction for the management of feline aural inflammatory polyps: a case review of 37 cats.

作者信息

Greci Valentina, Vernia Erika, Mortellaro Carlo M

机构信息

Gregorio VII Veterinary Hospital, Rome, Italy

Mapperly Vets4Pets, Nottingham, UK.

出版信息

J Feline Med Surg. 2014 Aug;16(8):645-50. doi: 10.1177/1098612X13516620. Epub 2013 Dec 23.

Abstract

Feline aural inflammatory polyps are benign growths originating from the tympanic cavity or the Eustachian tube. They usually occur in young cats, which present either signs of otitis externa and otitis media, or respiratory signs, depending on the direction of polyp growth. Neurological signs are also reported. Simple traction and ventral bulla osteotomy (VBO) are the most common techniques used for treating this condition in cats; corticosteroids are recommended to reduce risk of recurrence given the inflammatory nature of the disease. The most common complications after treatment are Horner's syndrome, polyp recurrence and facial nerve paralysis. The aim of this report is to describe the per-endoscopic trans-tympanic traction (PTT) technique for treating feline aural inflammatory polyps and to report the short- and long-term follow-up of this procedure. PTT allowed resolution of the aural inflammatory polyps in 94% of cats during a mean long-term outcome of 19 months. Three cats (8%) developed Horner's syndrome immediately after the PTT procedure, which resolved within a few weeks, and five cats had polyp recurrence (13.5%). Only two cats had a poor outcome and were diagnosed with chronic otitis media at 22 months, and chronic otitis media and polyp recurrence at 46 months after the PTT procedure, respectively. PTT was shown to be an effective technique for treating aural inflammatory polyps and registered fewer neurological complications (8%) than VBO (57-81%) or simple traction (43%), and a recurrence percentage (13.5%) similar to VBO (0-33%) and much lower than traction alone (57%).

摘要

猫耳炎性息肉是起源于鼓室或咽鼓管的良性肿物。它们通常发生于幼猫,根据息肉生长方向的不同,幼猫会出现外耳道炎和中耳炎的症状,或者呼吸道症状。也有神经症状的报道。单纯牵引术和腹侧鼓室切开术(VBO)是治疗猫这种疾病最常用的技术;鉴于该疾病的炎性本质,推荐使用皮质类固醇以降低复发风险。治疗后最常见的并发症是霍纳综合征、息肉复发和面神经麻痹。本报告的目的是描述用于治疗猫耳炎性息肉的经内镜经鼓膜牵引术(PTT),并报告该手术的短期和长期随访情况。在平均19个月的长期随访中,PTT使94%的猫的耳炎性息肉得到缓解。3只猫(8%)在PTT手术后立即出现霍纳综合征,几周内症状缓解,5只猫出现息肉复发(13.5%)。只有2只猫预后不良,分别在PTT手术后22个月被诊断为慢性中耳炎,以及在46个月时被诊断为慢性中耳炎和息肉复发。PTT被证明是治疗耳炎性息肉的一种有效技术,与VBO(57 - 81%)或单纯牵引术(43%)相比,其神经并发症较少(8%),复发率(13.5%)与VBO(0 - 33%)相似,远低于单纯牵引术(57%)。

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