Nasopharyngeal Dimensions of Brachycephalic Dogs & Middle Ear Inflammation & Effusion

Johnattan Arango, DVM, DACVS-SA, BluePearl Pet Hospital, Waltham, Massachusetts

ArticleLast Updated January 20222 min read
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In the literature

Krainer D, Dupré G. Influence of computed tomographic dimensions of the nasopharynx on middle ear effusion and inflammation in pugs and French bulldogs with brachycephalic airway syndrome. Vet Surg. 2021;50(3):517-526.


The Research …

Advanced cross-sectional imaging (eg, CT, MRI) has drawn attention to several abnormalities of brachycephalic breeds, as well as disorders associated with upper airway obstruction due to brachycephalic airway syndrome. Previous studies identified middle ear effusion as an incidental finding on advanced imaging1-3; obstruction and/or dysfunction of the auditory tube are potential causes.4 

This retrospective study aimed to identify the association between soft palate thickness and nasopharyngeal dimensions at the level of the auditory tube opening with the prevalence of middle ear inflammation and effusion in pugs (n = 30) and French bulldogs (n = 30). Dogs had no clinical signs of otitis and were evaluated with CT.

Although pugs have smaller cross-sectional nasopharyngeal airway dimensions at the level of the auditory tube opening, middle ear effusion and inflammation were more common in French bulldogs. The soft palate was, on average, thicker in French bulldogs than in pugs; however, middle ear effusion was only weakly correlated with soft palate thickness and nasopharyngeal dimensions. Bilateral effusion was significantly more common in French bulldogs than in pugs. As previously reported, the ventral wall of the tympanic bullae in French bulldogs was thicker than in pugs1; however, this finding was not correlated with signs of inflammation (eg, contrast enhancement, sclerosis) and likely indicates an anatomic variant, rather than inflammation, as the cause of the thickness. No abnormalities were observed in the external ear canal of any dog.


… The Takeaways

Key pearls to put into practice:

  • Owners of French bulldogs affected by brachycephalic airway syndrome should be made aware of a potential predisposition to otitis media. Clinicians should pay close attention to clinical signs and provide treatment as needed to avoid progression.

  • Lack of clinical signs of otitis externa does not rule out otitis media.

  • Increased thickness of the tympanic bullae may not be a sequela of middle ear inflammation in French bulldogs; instead, it may be a normal finding in this breed. Care should therefore be taken not to overinterpret this finding on diagnostic imaging.