Otitis Interna and its Clinical Management

Otitis interna define as inflammation of inner ear, which will be an extension of infection from the otitis media or secondary to the chronic otitis externa. Improperly treated / untreated cases of otitis media can lead to development of otitis interna by involving the tympanic membrane. Clinical signs in otitis interna were impairment of hearing apparatus i.e. deafness and neurological indications such as tilting of the head towards the based on the side of the ear affected, development of the horizontal or rotary nystagmus, unequal legs coordination with diffused strength, circular walking pattern, sudden collapse, and even rolling towards the impacted side. Complication of otitis interna leads to development of life-threatening iotrogenic intracranial infections and meningitis by travelling the infectious organisms to the brainstem. In dogs with severe otitis interna that progressed to an intracranial infection, changes in mentation, ataxic changes, paresis, proprioceptive deficits, and development of seizures. Diagnosis of the otitis interna achieved by detailed history; dermatological, neurological and systemic examination along with the identification of underlying and/or associated factors. Otoscopic examination, cytology, microbial culture, antibiotic sensitivity test, radiography, computerized tomography scan evaluation and magnetic resonance imaging are helpful to differentiate the extent of lesions and severity. Medical management of otitis interna is carried out by identifying the suitable antibiotic by antibiotic sensitivity test followed by the correct dosage and duration approximately ranging from 4 to 8 weeks along with the systemic corticosteroids which have been advised to reduce the stenosis. When there is rupture of tympanic membrane, cautious utilization of topical antibiotic and/or anti-inflammatory preparations are advisable. If medical management fails to respond, surgical intervention are advised with vertical ear canal ablation, lateral ear canal resection, total ear canal ablation with lateral bulla osteotomy.