Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats

Shannon H. Wainberg 1VCA Canada Alta Vista Animal Hospital, 2616 Bank St, Ottawa, ON K1T 1M9, Canada.

Search for other papers by Shannon H. Wainberg in
Current site
Google Scholar
PubMed Close
 DVM
,
Laura E. Selmic 2Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Search for other papers by Laura E. Selmic in
Current site
Google Scholar
PubMed Close
 BVetMeD, MPH
,
Annika N. Haagsman 3Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, 3584 CL Utrecht, The Netherlands.

Search for other papers by Annika N. Haagsman in
Current site
Google Scholar
PubMed Close
 DVM
,
Stan Veytsman 4MedVet Medical & Cancer Centers for Pets, 3964 Red Bank Rd, Fairfax, OH 45227.

Search for other papers by Stan Veytsman in
Current site
Google Scholar
PubMed Close
 DVM
,
Karl C. Maritato 4MedVet Medical & Cancer Centers for Pets, 3964 Red Bank Rd, Fairfax, OH 45227.

Search for other papers by Karl C. Maritato in
Current site
Google Scholar
PubMed Close
 DVM
,
Brian J. Trumpatori 5Veterinary Specialty Hospital of the Carolinas, 4640 Paragon Park Rd, Raleigh, NC 27616.

Search for other papers by Brian J. Trumpatori in
Current site
Google Scholar
PubMed Close
 DVM
,
Allison B. Putterman 5Veterinary Specialty Hospital of the Carolinas, 4640 Paragon Park Rd, Raleigh, NC 27616.

Search for other papers by Allison B. Putterman in
Current site
Google Scholar
PubMed Close
 VMD
,
Michelle L. Oblak 6Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

Search for other papers by Michelle L. Oblak in
Current site
Google Scholar
PubMed Close
 DVM
,
Joshua S. Montel 7Wheat Ridge Veterinary Specialists, 10140 West 44th Ave, Wheat Ridge, CO 80033.

Search for other papers by Joshua S. Montel in
Current site
Google Scholar
PubMed Close
 DVM
,
Larie Allen 7Wheat Ridge Veterinary Specialists, 10140 West 44th Ave, Wheat Ridge, CO 80033.

Search for other papers by Larie Allen in
Current site
Google Scholar
PubMed Close
 DVM
,
Antoine Dunié-Mérigot 8Clinique Vétérinaire Languedocia, 395 rue Maurice Béjart–Parc 2000, 34080 Montpellier, France.

Search for other papers by Antoine Dunié-Mérigot in
Current site
Google Scholar
PubMed Close
 DMV
,
Michael B. Mison 9Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Search for other papers by Michael B. Mison in
Current site
Google Scholar
PubMed Close
 DVM
,
Julia P. Sumner 10Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

Search for other papers by Julia P. Sumner in
Current site
Google Scholar
PubMed Close
 BVSc
,
Ronan A. Mullins 11Section of Veterinary Clinical Sciences, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.

Search for other papers by Ronan A. Mullins in
Current site
Google Scholar
PubMed Close
 MVB
,
Sarah Malek 12Department of Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

Search for other papers by Sarah Malek in
Current site
Google Scholar
PubMed Close
 DVM
,
Malgorzata M. J. Bielecki 13Tierklinik Haar, Keferloher Strasse 25, D-85540, Haar, Germany.

Search for other papers by Malgorzata M. J. Bielecki in
Current site
Google Scholar
PubMed Close
 Mag med vet
,
Leslie E. Fox 14Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011.

Search for other papers by Leslie E. Fox in
Current site
Google Scholar
PubMed Close
 DVM, MS
,
Claire Legallet 1VCA Canada Alta Vista Animal Hospital, 2616 Bank St, Ottawa, ON K1T 1M9, Canada.

Search for other papers by Claire Legallet in
Current site
Google Scholar
PubMed Close
 DVM
, and
Julius M. Liptak 1VCA Canada Alta Vista Animal Hospital, 2616 Bank St, Ottawa, ON K1T 1M9, Canada.

Search for other papers by Julius M. Liptak in
Current site
Google Scholar
PubMed Close
 BVSc, MVetClinStud
DOI:
https://doi.org/10.2460/javma.255.7.828
Volume/Issue:
Volume 255: Issue 7
Online Publication Date:
01 Oct 2019
Restricted access
Sign In Reprints and Permissions Purchase Article

Abstract

OBJECTIVE

To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats.

ANIMALS

282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016.

PROCEDURES

Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables.

RESULTS

Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently.

CONCLUSIONS AND CLINICAL RELEVANCE

Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Abstract

OBJECTIVE

To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats.

ANIMALS

282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016.

PROCEDURES

Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables.

RESULTS

Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently.

CONCLUSIONS AND CLINICAL RELEVANCE

Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Contributor Notes

Dr. Wainberg's present address is Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.

Dr. Selmic's present address is Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

Dr. Veytsman's present address is Veterinary Medical Center, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108.

Dr. Putterman's present address is Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

Address correspondence to Dr. Liptak (animalcancersurgeon@icloud.com).
Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
Publication Date:
01 Oct 2019

  • 1. Fan TM, de Lorimier LP. Inflammatory polyps and aural neoplasia. Vet Clin North Am Small Anim Pract 2004;34:489–509.

  • 2. Muilenburg RK, Fry TR. Feline nasopharyngeal polyps. Vet Clin North Am Small Anim Pract 2002;32:839–849.

  • 3. Anderson DM, Robinson RK, White RAS. Management of inflammatory polyps in 37 cats. Vet Rec 2000;147:684–687.

  • 4. Faulkner JE, Budsberg SC. Results of ventral bulla osteotomy for treatment of middle ear polyps in cats. J Am Anim Hosp Assoc 1990;26:496–499.

    • Search Google Scholar
    • Export Citation

  • 5. Kapatkin AS, Matthiesen DT, Noone KE. Results of surgery and long-term follow-up in 31 cats with nasopharyngeal polyps. J Am Anim Hosp Assoc 1990;26:387–392.

    • Search Google Scholar
    • Export Citation

  • 6. Trevor PB, Martin RA. Tympanic bulla osteotomy for treatment of middle ear disease in cats: 19 cases (1984–1991). J Am Vet Med Assoc 1993;202:123–128.

    • Search Google Scholar
    • Export Citation

  • 7. Smeak DD. Management of complications associated with total ear canal ablation and bulla osteotomy in dogs and cats. Vet Clin North Am Small Anim Pract 2011;41:981–994.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 8. Anders BB, Hoelzler MG, Scavelli TD, et al. Analysis of auditory and neurological effects associated with ventral bulla osteotomy for removal of inflammatory polyps or nasopharyngeal masses in cats. J Am Vet Med Assoc 2008;233:580–585.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 9. London CA, Dubilzeig RR, Vail DM, et al. Evaluation of dogs and cats with tumors of the ear canal: 145 cases (1978–1992). J Am Vet Med Assoc 1996;208:1413–1418.

    • Search Google Scholar
    • Export Citation

  • 10. Bacon NJ, Gilbert RL, Bostock DE, et al. Total ear canal ablation in the cat: indications, morbidity, and long term survival. J Small Anim Pract 2003;44:430–434.

    • Crossref
    • Search Google Scholar
    • Export Citation

  • 11. Sano T, Nishmura R, Mochizuki M, et al. Clinical usefulness of propofol as an aesthetic agent in dogs and cats. J Vet Med Sci 2003;65:641–643.

  • 12. Little CJL, Lane JG. The surgical anatomy of the feline bulla tympanica. J Small Anim Pract 1986;27:371–378.

  • 13. Barlow CM, Root WS. The ocular sympathetic pathway between the superior cervical ganglion and the orbit of the cat. J Comp Neurol 1949;91:195–207.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement