Video: Ventral Bulla Osteotomy in a Cat

Daniel A. Degner, DVM, DACVS, Animal Surgical Center of Michigan, Burton, Michigan

ArticleLast Updated September 20121 min readWeb-Exclusive
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Ventral bulla osteotomy is often performed to remove inflammatory polyps in cats. This exclusive video shows you a step-by-step procedure.
  1. A skin incision is made to expose the left bulla.

  2. The jugular bifurcation is identified and the dissection is continued rostral to this.

  3. The retractor pins are repositioned to provide better exposure to the bulla.

  4. The thin pterygoid muscle is separated in order to expose the oval-shaped bulla.

  5. A Steinmann pin is used to start the osteotomy in the bulla.

  6. Rongeurs are used to carefully remove the bone in order to expose the entire ventromedial compartment of the bulla.

  7. The round window (RW) can be seen in the promontory (P)

  8. The septum (S), which separates the ventromedial from dorsolateral compartment, is identified.

  9. The sympathetic nerves run over the ventral aspect of the promontory and through a thin opening in the septum.

  10. A suture is placed through the thin opening in the septum that communicates between the two compartments.

  11. The osteotomy in the septum is initiated with a Steinmann pin. Rongeurs are used to remove the septum and the remaining lateral wall of the bulla.

  12. A suture is placed in the opening of the auditory tube, which is the typical location of the root of an inflammatory polyp.