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Feline Oronasopharyngeal Polyp

December 9, 2012

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short-haired tabhy at asleep on Doc Truli's surgery table

Sedated Tabby with Pupils Dilated

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.

2-year-old tabby cat has ear surgery to remove polyp blocking the ear canal

Magnifying an Ear Polyp

“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

This side view of a cat skull x-ray looks normal

Normal Cat Skull X-Ray

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.

This x-ray shows thickening of the bone surrounding the inner ear of a cat

Thickened feline bulla

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

1 cm (1/2 inch) squishy pink tube of polypoid inner ear mucusal lining removed from a cat's ear canal

Oropharyngeal Polyp

Bulla Osteotomy

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’s Recovery

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!

21 Comments leave one →
  1. October 13, 2013 12:40 pm

    Please help! My cat is 15yrs old. About 3 years ago his ear flap started scrunching up and is now deformed. We thought he had an ear infection and was treated. He never showed any symptoms. Then, these weird polyps started growing inside his ear. Numerous ones that are very rigid and look/feel like bony structures. Now these polyps are green like mold. There is no secretions coming from them. They are very dry and fill his ear canal completely. I am sure that is why his ear flap has shriveled. I am sure he can’t hear out of that ear, although this condition doesn’t seem to bother him at all. My vet has told me there is nothing I can do about this, has never seen anything like it. Have you seen this? Is there anything I can do?
    Please help! I feel like, in taking my vet’s advice, I waited too long and now this is irreversible.
    Thank You,

    • October 14, 2013 6:54 am

      Look up ear hematoma untreated. Look up melanoma in situ. And look up hyperplasia cerumen glands. These are my top three ideas based on what you wrote.

    • Nadine Baldock permalink
      May 28, 2014 7:32 am

      A similar sounding case. My cat is 15 and a half and her right ear is full of polyps causing her to shake her head and scratch(the other ear has the beginnings of polyps). The polyps in her right ear have almost completely blocked the ear canal. My vet has said there is nothing to be done in a cat of her age except give her steroid tablets to try and keep her comfortable. The polyps seem to be growing steadily larger, is there anything else that can be done to help her?

      • May 28, 2014 8:01 pm

        Dear Nadine,
        The polyps in this story occur in young cats only. They grow from the lining of the middle ear. I’m betting the “polyps” your cat has are either overgrown cerumen glands or melanoma in situ growths. The cerumen glands might calm down with prednisone. The melanoma in situ does not spread in the body usually, but it can block the ear canal. Depending where they are in the canals, you could investigate surgical removal, however, if they are deep in there, the surgery would be extensive and have significant potential side effects (I probably would not put my cat through it!)

        Do you have a pure homeopathic vet you can consult? Perhaps homeopathic medicine would offer help. Homeopathics is no quick fix, be aware of that!

        Good luck,
        Doc Truli

  2. Alex permalink
    July 18, 2013 10:12 pm

    Hello. I found this after our vet diagnosed our cat with an ear polyp. He had an ear infection for two months before they finally found out what it was, unfortunately. Since our vet referred us to a specialist in Maitland Florida, we are a little nervous and concerned with how long he has had it as well as the cost. How much does this removal procedure typically cost? I am not even sure if he is physically able for surgery; he is 14 and severely obese (we adopted him when he was 9 and lost some weight but won’t budge from 35 pounds). My other concern is do ear polyps cause pupil dilation? For about a year and a half he has slowly lost the color in his eyes and now only has huge dialated pupils and are unresponsive to light. Could this polyp have caused this? We did extensive testing and the vet could not explain it.

    Sorry for the lengthy comment.

    • Alex permalink
      July 18, 2013 11:01 pm

      I am also very nervous about this specialist. I live in Orlando and this is apparently the only vet in the area who deals with such cases and I have read terrible reviews. I read you practice in Clearwater? I would be more than willing to drive hours for him.

      • July 19, 2013 7:42 pm

        I would love to meet you and your cat. I can tell you, I would probably refer you to a specialty surgeon ( there are several excellent ones I know personally in this area.)

        In Orlando, I know of an Orlando veterinary specialists hospital that my clients spoke highly of. Plus, remember, specialty surgeons may be excellent surgeons but not great communicators. So they might incur negative reviews but have technically been impressive.

        Make sure you are referred to an experienced specialist. If you would
        like a consult with me, you can message me on Facebook with your email.

        -Doc Truli

    • July 19, 2013 7:38 pm

      Hi Alex,
      Thanks for reading VirtuaVet.
      Polyps are typically in cats under 2 years old, not usually 14.
      The work-up and surgery in a medium cost area of the US would probably be about $1,800 for surgery and intensive care after. A CT scan would help your surgeon identify the size and shape of what your cat has. That adds about $1,500 to the cost.

      So if your vet is under that cost (which I bet they are in maitland) that would be about right. That kind of ear/head surgery is highly technical. Do not hesitate to ask your vet the risks and potential side-effects for your kitty.

      Good luck!
      -Doc Truli

      • alex permalink
        July 19, 2013 7:56 pm

        Thank you so much for getting back to me. I sent you a message on facebook.

  3. July 9, 2013 3:33 pm

    Sorry this is going to be a long comment! My husband and I are getting pretty desperate. Our kitty has been healthy until recently. She started shaking her head months ago (when she was about 1.5 years old) and I took her to the doctor. They looked in her ears, ran a few cultures, and said everything was A-OK. The symptoms persisted so I took her to another vet last week. After leaving the vet, she had some sort of gagging/hacking/asthma attack. She’s never had anything like it before. Below is a list of all her symptoms. Do you think she has polyps? We are taking her in for a CT scan at a surgeon tomorrow. However this will be extremely expensive and I just want to be relatively sure before we drag her to another vet and risk another life threatening asthma attack!

    most frequent/serious symptoms:

    asthma attacks- hacked/gagged and hyperventilated 3 times (once for 10 minutes, the other times about 10 seconds)

    Flicks her ears and shakes her head often (for months)

    Scratches ear and chin

    Twists head and lays down ear

    Wakes up and shakes head

    Sleeps on her ears

    breathing issues:


    licking nose

    sniffing the air

    hoarse voice

    wet nose

    sleeps with her butt in the air and her chin on the ground (new development)

    occasional swallowing 3-4 times in a row






    may have swollen salivary glands

    neurological signs:


    shaky head

    off balance


    twice she looked not in control of her body (ataxia)

    possible Horner’s syndrome


    Hyperesthesia has gotten worse- loud and painful sounding meows

    Suspected hearing loss, possible reduction in sense of smell

    Suspected eye issues

    Some slight disorientation


    Hard buffing

    Bald spot on her chin with red dots in it

    Constant although minimal eye discharge

    has lost 1 pound in 2 months, making her 9 lbs

    may be constipated

    feces is very stinky

    Risk factors:

    possibly has herpes

    The other cat in our house shows similar symptoms (i.e. environmental cause is a possibility?)

    Sorry for the long post!

    • July 9, 2013 8:28 pm

      Wow! I’m so glad she is seeing a specialist. The CT (that’s computed tomography) should show any physical
      Issues like polyps. Please, please let us know the results.

  4. soldierswife68 permalink
    March 27, 2013 9:57 am

    Hi! I just ran across your website, searching for information on nasal polyps in cats. I have a 16 year old Maiine Coon, who is in great health – other than constant congestion that has been ongoing for more than 3 months now. After unsuccessful treatment by our vet on 2 separate visits (with antibiotics and steroid shots), I am suspecting nasal polyps are the culprit. He did an xray, which did show an abnormality with one of her ear bullas and only said she might have some hearing loss due to that. He never mentioned polyps, but that is what it’s looking like to me. She is now sneezing constantly and has a slight, thick, milky looking discharge coming from one of her nostrils. Do you think she is too old to sedate in order to remove the polyp(s), or to at least have a better look into her ear canal or back of throat, if there is one (or more) present? What would you recommend for a cat her age? She is either going to die from suffocation or possibly die if she is sedated for polyp removal, so which would be the better choice? Right now, she is just miserable.

    • March 27, 2013 11:36 am

      Hi! Thanks for reading VirtuaVet.
      Nasal polyps typically occur in cats under two years old. Pretty much that’s it. I seriously doubt your kitty has polyps.

      Sinus/bulla problems can be frustrating to diagnose and treat. It sounds like your vet took it as far as they can with regular diagnostics.

      I recommend two things. One, ask your vet to do a nasal cytology (if they did not already). Sometimes there’s a fungus or cancer cells that could show on this simple test.

      #2 you need a referral from your veterinarian to take your kitty to a specialist. A computed tomography CT scan may be needed. And/or anesthesia and rhinoscopy with biopsies and cultures taken.

      Of course, these are just my thoughts and no substitute for your vet’s advice.
      Good luck!

      -Doc Truli

  5. December 9, 2012 8:56 pm

    Great post, very in-depth and easy to understand. Liked your explanation of ear mite disease, too. Not sure why, but it’s ALWAYS the thing that clients are SURE their cat has…

    • December 9, 2012 9:42 pm

      I know! How many cats get their little ears burned by ear more meds on top of being sore with infection in the first place? Ouch!

      I hope to teach kitty parents about demographics. Knowing what breeds and what ages get certain diseases gets your doctor to a diagnosis faster. I leaned it’s what sets Specialists apart, too. They know those research demographics super well!

      So, ear mites are contagious from other furry critters. If your cat hasn’t been around a furry critter, your cat does not have ear mites!

      Thanks for your feedback, Terri!

      -Doc Truli

  6. tigersvalet permalink
    December 9, 2012 6:26 pm

    Thanks for this article! My buddy Tiger was presenting some symptoms described here. After reading this piece, I ran him down to his Vet. (I’m in training to become a Vet. Tech.) He just had a mild infection though. Better safe that sorry!

    • December 9, 2012 7:22 pm

      Turned out maxi had an ear infection for months and her folks did not realize. Upper respiratory infection is much, much more common! I’m so happy to hear your kitty got some help and is going to be all better.

      Doc Truli

  7. December 9, 2012 5:36 pm

    I wish you were our veterinarian.

    • December 9, 2012 7:20 pm

      Thanks! Clearwater Florida is a fantastic place to live. If you ever hanker for a change, get in touch and I’ll help you! Plus, I like your designs on your site!

      • September 19, 2013 7:16 pm

        Here is my actual website…
        All of my resources are free. Thank you.

        I live in California, I am tech but no longer working as one. I have worked for a few veterinarians and though they all did their jobs wonderfully, it was easy to see which ones had their heart into it.
        I have respect for most all veterinarians, I have worked a long side them and the job you all do is not easy. But I must say that there are those who really stand out in my mind along the way and usually they were the ones that stayed late to care for that lab puppy who had parvo or the ones who refused to put an animal down just because they were homeless or unwanted. And the ones like you who notice the little things that a lot of vets miss.
        Even though I know some of what you talk about , there is just so much that I learn here. What you are doing is fabulous, it goes above and beyond just being a vet. It is that something extra that you do that makes me wish you were our veterinarian.
        The article that you posted about what cats look like when they are in pain was amazing to me. There are so many people that just don’t recognize this because cats are so good at hiding pain. I believe that your post will change the course of illness for many cats because of those photographs. The post was a brilliant idea and I recommend it to anyone I know who has questions about whether their cat is in pain.
        If I had worked for someone like you I would still be working as a tech, that’s for sure. Thank you for loving animals so much and doing all you can to help them. This world is a better place because of people like you.

        I appreciate and respect what you do.

      • September 25, 2013 11:06 am

        Thank you Jenny.

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