Ear Anatomy and Cytology Clinical Pathology Normal anatomy • The ear canal is a cartilaginous structure lined with skin (epithelium). • Hair follicles, sebaceous glands, and apocrine glands line the entire canal to the eardrum. • In the normal ear, glandular secretions and epithelial cell migration, move dirt and debris away from the ear drum. • A normal ear exam should reveal a smooth, noninflamed epithelial lining and an intact tympanic membrane. Anatomy continued….. • The tympanic membrane is a thin, semitransparent membrane that separates the external canal from the tympanic cavity. • Transmits sounds to the hearing apparatus. Otitis • Definition: Inflammation of the ear canal and/or pinnae. Otitis externa • Inflammation of the ear canal to the tympanic membrane. Otitis Media • Inflammation of the tympanum and the tympanic bullae. Otitis Interna • Inflammation of the hearing apparatus. • Neurologic signs and deafness are usually present. Causes of ear disease • • • • • • Abnormal conformation Ectoparasites Systemic diseases, allergies, endocrine disease. Tumors Foreign bodies Trauma Diagnosis of ear problems • Clinical signs: ▫ Inflamed ear canal ▫ Color of discharge ▫ Neurological signs • Otoscopic exam • Ear swab cytology • Culture/sensitivity Ear Cytology Technique • Using a cotton tip applicator, gently swab ear canal. • Gently roll the swab along a clean glass slide. • Heat fix • Stain ▫ Diff-quick ▫ Gram stain Cytological exam • Bacteria ▫ Rods or cocci Pseudomonas, Proteus, Staphlococcus, Streptococcus • Yeast ▫ Malassezia pacydermatitis • WBC’s ▫ neutrophils • Epithelial cells • Neoplastic cells • Earmites Bacterial Otitis • May see large numbers of bacteria, often phagocytized bacteria in neutrophils. • May see large numbers of neutrophils. • May have mixed infections (rods and cocci) • Discharge color ▫ Creamy, dark, yellow-light brown usually is Staph/Strep ▫ Thick, odorous, pale yellow discharge usually is Pseufomonas, Proteus • Do culture/sensitivity especially if rods are found Malassezia Otitis • • • • Yeast are normal inhabitants >10 yeast/HPF is abnormal. Discharge: dark brownish exudate, yeasty odor. May be present with bacteria (mixed infection). Treatment of Otitis • Depends on organism causing problems. • Topicals ▫ Antifungals ▫ antibacterials • Systemic drugs ▫ Antibiotics ▫ Antifungals • Treat underlying disease