Feline Oronasopharyngeal Polyp
An ear infection or signs of a cold in a cat
“Doc, Maxi is sneezing and she keeps shaking her head,” said Susie, Maxi’s human and caretaker. Doc Truli examined the 2-year old grey tabby domestic short-haired kitty. She looked strong and healthy in almost every way. Except her right eye watered a lot and her right ear stayed flattened out to the side if her head like an airplane wing.
Doc Truli had an idea that she might find a polyp somewhere in the ear or the pharynx (the back of the throat). Susie thought Maxi had earmites.
“I gave her two courses of earmite medicine from the pet store, but it really seemed to aggravate her,” said Susie.
“If you have an indoor, two-year-old cat with a new ear problem and you have not brought other animals into the house in weeks or months, your pet almost certainly does not have earmites,” says Doc Truli. “Please do not waste your time, money, and your pet’s health on over-the-counter earmite medicine. See the veterinarian!”
“Let’s have a look in that ear,” said Doc. Young cat, painful ear and runny eye, no outside animals, stays indoors. Hmm…under two years is a perfect age for a polyp.
Doc Placed the magnifying otoscope to the ear. Maxi was not thrilled by the strange new sensation, but she sat pretty for the examination. The otoscope automatically lights and magnifies the ear canal for the doctor. (A decent one costs about US$350, inexpensive nurse otoscopes are about US$20 at many uniform supply stores.)
Doc Truli could only make out a red, sore, wet ear canal full of yellow-white pustular liquid goo. If there’s a polyp in here, we’re going to have to look deeper.
What is an OroNasoPharyngeal Polyp???
“I suspect Maxi has an oronasopharyngeal polyp that is blocking her ear canal and causing lingering infection,” said Doc Truli.
“I do not understand anything you just said. Can’t we just give her an antibiotic?” said Susie.
Let’s break this one down. Oro – pertaining to the oral cavity, naso or nasal – pertaining to the nose, and pharyngeal – pertaining to the pharynx (the back of the throat where the windpipe and the esophagus start). And polyp, a growth that is sort of oval or elongated and dangly. You know, a polyp.
“How could this happen?” said Susie.
Oronasopharyngeal polyps grow from the lining of the inner ear. The inner ear lies at the back and base of the skull where you can full two rounded areas, one on either side of the base of your cat’s skull. They are normally air-filled with a bony bridge called a septum running through the middle of each one to carry important nerves (like a conduit for cable).
A polyp forms when the inner ear lining just grows and grows. It fills the inner ear and then starts into the middle ear and then chooses to either go down the eustachian tube to the pharynx and the back of the mouth or it can grow out through the eardrum to the external ear canal.
“Oh, good grief,” said Susie, “How do we get the thing out?”
“X-rays first,” said Doc Truli.
Radiographs (X-Rays) to Look for a Polyp
We sedated Maxi so she could be perfectly still for a finely detailed skull x-ray. The side view – called lateral – shows the bulla on the back and bottom of the skull. (The bulla look like curves of white on the x-ray at the back and bottom of Maxi’s skull.) The second x-ray showed us what we wanted to see.
Some cats will have a polyp that does not completely fill the inner ear (bulla). In Maxi’s case, You can see a big circle on the left of the radiograph at the back of the skull. It looks much thicker and whiter than the one on the right and even looks a little white inside the bony bulla space. Maxi had a polyp!
Susie was really worried at this point,”Is my kitty just going to have this thing forever?”
Doc Truli laid out the options for Maxi’s polyp situation.
Surgery for OroNasopharyngeal Cat Polyps
Doc Truli took Maxi straight from the radiology department to surgery. Maxi needed a procedure called a bulla osteotomy. In this surgery, a hole is drilled through the bone encasing the inner ear in order to reach the inside and clean out the lining.
“Maxi needed the bulla osteotomy because our goal is to clean out the entire abnormal lining of the inner ear, including the polyp extending to the eardrum in order for Maxi to recover from her ongoing infection,” said Doc Truli.
Side Effects of Bulla Osteotomy
One major side effect of the surgery is the chances of irritating or even cutting the facial nerve (otherwise known as cranial nerve 7). An inflamed facial nerve can cause partial facial paralysis. In cats, facial paralysis can look like a sunken eye globe, drooping lip, and tearing of the eye. It usually resolves within weeks after the surgery. But there is a chance it becomes permanent.
Maxi recovered from surgery uneventfully. Her face drooped for 3 days, but she could eat and drink and she took her medication just fine. After two weeks, no one could tell anything had ever happened to her!
Susie was so pleased,”My Maxi is back! She’s been on the bed and sitting on the sofa with me instead of hiding under the bed like she used to.”
We know Maxi could grow another polyp. Scientists do not know what triggers some cats to grow these polyps. For now, Maxi is a happy cat!