Otoscopic, cytological, and microbiological examination

of the equine external ear canal

Blackwell Publishing Ltd

Sandra J. Sargent, Linda A. Frank,

Benjamin R. Buchanan*, Robert L. Donnell
and Federica Morandi
University of Tennessee College of Veterinary Medicine,
Department of Small Animal Clinical Sciences, C247 VTH,
Knoxville, TN 37996-4544, USA
Correspondence: Sandra J. Sargent, University of Tennessee
College of Veterinary Medicine, Department of Small Animal
Clinical Sciences, C247 VTH, Knoxville, TN 37996-4544, USA.
E-mail: sjsargent@utk.edu.
*Present address: Brazos Valley Equine Hospital, 6999 Highway
6 North, Navasota, TX 77868, USA.

Abstract
Otoscopic examination and cytology of the equine ear
would be beneficial in diseases such as head trauma,
headshaking, otitis externa secondary to otitis media,
vestibular disease, aural neoplasia and aural pruritus
secondary to parasites. In practice, otic examinations
of horses are rarely done due to the perceived difficulty in visualizing the equine external ear canal and
tympanic membrane, as well as the need for chemical
restraint. In this study, the proximal external ear canal
was examined in live horses using a handheld otoscope and in cadaver heads using video otoscopy.
Visualization of the proximal ear canal of the sedated
horse could be done with a handheld otoscope, but
more sedation or general anaesthesia and a video
otoscope would be required to adequately visualize
the tympanic membrane in the live horse. The proximal
ear canals of 18 horses were examined cytologically
and cultured aerobically. In three horses, both ears
were sampled. No cells or organisms were seen on
cytological examination of 11/21 ears. Nine of the 21
ears were sterile when cultured. Ten of the 21 ears had
mixed growth with low numbers of organisms
(Corynebacterium sp. being most common). Two of
the 21 ears had heavy growth of a single organism
(Corynebacterium sp. and Staphylococcus intermedius,
respectively). Equine cadaver heads were examined in
cross-section by computed tomography (CT) imaging
and histopathology in order to further understand the
anatomy of the equine external ear canal. Equine
practitioners should be aware that otic examination
is possible and may provide important diagnostic
information.
Accepted 6 March 2006

Introduction
Sparse information is available about examination of the
equine external ear canal. Descriptions of the normal anatomy
and appearance of the external ear canal and tympanic
membrane of the horse are rare and may be misleading.1
There have been no published studies on the microbial
flora and cytology of the external canal in normal horses.
Otoscopic examination and cytology would be beneficial
in diseases such as head trauma, headshaking, otitis
externa secondary to otitis media, vestibular disease, aural
neoplasia and aural pruritus secondary to parasites. Other
rare disorders such as muscle spasms associated with ear
tick infestations have been reported and may go undiagnosed without an otic examination.2 However, in practice,
otic examinations of horses are rarely done. This may be
due to the perceived difficulty in visualizing the equine
external ear canal and tympanic membrane as well as the
need for chemical restraint. The tympanic membrane of
the horse is considered to be difficult, if not impossible, to
visualize by most equine practitioners. Previous references
state that general anaesthesia is required for examination
of the tympanic membrane and myringotomy in the horse.3
Headshaking is an increasingly recognized syndrome
and presents as uncontrollable, spontaneous, rapid and
repetitive head movements without apparent cause.
Although the majority of cases of headshaking in the horse
are idiopathic, several different underlying diseases
including otitis externa, media or interna, otic foreign
bodies or ear mites can be present.4 The importance of
eliminating any definable cause by thorough examination
is emphasized due to the poor prognosis for treatment of
idiopathic headshaking.5 A thorough otic examination is
needed to rule out aural disease as an underlying cause of
this debilitating condition. However, there is little discussion in the literature of techniques that enable visualization
of the proximal ear canal and tympanic membrane. In a
review of 20 cases of headshaking, a standard routine of
diagnostic tests was described to allow for identification
of any underlying cause prior to making the diagnosis of
idiopathic headshaking.5 This included aural endoscopy
using a 4-mm fibreoptic paediatric endoscope and radiography of the head. However, further details regarding this
instrumentation and the technique utilized for aural endoscopy were not mentioned. As this equipment is not readily
available to most equine practitioners, the use of more
commonly available instruments that are often used to
visualize the external canal and tympanic membrane of
other species needs to be explored.
Diseases of the external ear canal of the horse are considered to be uncommon and few reports of otitis externa
as a primary disease can be found in the literature. Otitis
externa secondary to otitis media is more commonly

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SJ Sargent et al.

reported.6 Otitis media is an insidious disease in the

equine. The early clinical signs of otitis media include ear
rubbing, head tossing or head weaving. These signs are
frequently attributed to parasites in the ear canal or behavioural problems and may go unnoticed.7 Rupture of the
tympanic membrane and presence of external ear drainage is reported to be uncommon with the majority of
cases of otitis media.8,9 However, in a report describing
endoscopy of the auditory tube diverticula (guttural pouch)
in four horses with otitis media/interna, three of the four
horses had otic examinations and in all of these horses the
tympanic membrane was ruptured.3 The authors did not
examine the ear canal in one of the horses due to the risk
associated with general anaesthesia and it was not
mentioned whether otic examination was attempted without general anaesthesia. Knowledge of the anatomy and
appearance of the normal tympanic membrane could
result in earlier diagnosis of otitis media, thus avoiding the
serious neurological complications that occur months to
years after onset. Development of a transtympanic
membrane tap was mentioned by one author as an aid to
earlier diagnosis but would be difficult without excellent
visualization of the proximal canal and tympanic membrane.7
The purpose of this study was to determine whether the
proximal external ear canal and the tympanic membrane
of the horse can be visualized using available equipment
such as a handheld or a video otoscope, and to document
the microbial flora of the normal equine external ear canal
through cytology and culture of samples collected from
live horses. Cross-sectional imaging using computed
tomography (CT) and histopathology of equine cadaver
heads were also performed to allow further understanding
of the anatomy of the equine external ear canal.

Materials and methods

Animals
Four adult equine cadaver heads (unknown breeds and ages) were
utilized to determine the best method of visualizing the proximal
portion of the external ear canal and to determine whether the tympanic
membrane could be consistently seen. Pictures of the proximal and
distal canal were obtained using video otoscopy.
Eighteen clinically healthy horses (unknown ages, different breeds
and sexes) with no history of ear disease were randomly selected
from the teaching herd at the University of Tennessee. The horses
were restrained in individual stocks and sedated with intravenous
xylazine, and a nose twitch was applied to supplement the restraint.
To minimize stress, only one ear was examined and sampled in all
but three horses where both ears were examined and sampled. This
protocol was approved by the Institutional Animal Care and Use
Committee.

present and partially obstructing the tip of the cone after introduction
into the proximal canal, a second attempt was made with a new sterile cone in the effort to obtain a sample free of cerumen from the outer
portion of the canal. Once the proximal portion of the ear canal was
visualized, a sterile microtip swab (BBL CultureSwab with Amies gel;
Becton, Dickinson and Co., Sparks, MD, USA) was passed through
the sterile cone. The swab was immediately placed into transport
media upon removal from the canal. A second swab was then introduced in the same manner to collect a sample for cytological examination. This swab was immediately rolled onto a new glass slide and
labelled with each horses identification number.

Cytology
The glass slides were briefly heat fixed. They were then stained with
a commercial staining solution (3 Step Stain; Richard-Allan Scientific,
Kalamazoo, MI, USA) and allowed to air dry. Each slide was first examined under 10 for the obvious presence of debris, cells or organisms
before proceeding to examine under the 100 oil immersion lens. The
entire slide was examined and numbers of organisms were recorded.

Bacterial cultures
The microtip swabs were submitted to the microbiology laboratory of
the University of Tennessee for routine aerobic culture. Each specimen
was inoculated onto one quadrant of Columbia agar with 5% sheep
blood, Columbia agar with colistin nalidixic acid and MacConkey agar
and streaked for isolation. The Columbia agars were incubated at
35 C in 7% CO2. The MacConkey agar and thioglycolate broth were
incubated aerobically at 35 C. The plates and broth were examined
daily for a total of 5 days. All colonies were enumerated, gram stained
and identified to genus level.

Computed tomography
The head of a 15-month-old Arabian horse that had no clinical signs of
otitis media or externa and was euthanized for reasons other than
neurological disease was disarticulated at the atlanto-occipital joint
and prepared for CT. Using a fourth-generation CT scanner (Marconi
PQ 6000, Universal Medical Systems, Inc., Solon, OH, USA), axial
overlapping images at 3 mm collimation and 2 mm intervals were
acquired through the tympanic bullae with a sharp (edge-enhancing)
algorithm. Images were viewed in both bone (window width = 2500
HU, window level = 500 HU) and soft tissue windows (window
width = 350 HU, window level = 50 HU).

Histopathology
The external ear canal of one cadaver head was cross-sectioned at the
area of the proximal canal and tympanic membrane for gross visualization. The head was then sectioned for histological evaluation of the
proximal canal and tympanic membrane. Segments of the temporal
region of the skull were fixed in 10% buffered neutral formalin for
5 days and then transferred into fixative decalcifier (Formical-4, Decal
Chemical Corp. Talman, NY, USA) until selected areas were sufficiently softened to be trimmed with a knife. The segments were
routinely processed for paraffin embedding, sections cut at 6 m and
stained with haematoxylin and eosin (H&E) for microscopic examination.

Results
Visualization of the ear canal and sample collection
A handheld otoscope (3.5v Halogen Pneumatic Otoscope; Welch
Allyn Medical Products, 4341 State Street Road, Skaneateles Falls,
NY, USA) with a 7-mm cone and a video otoscope (Vetcam XL Otoendoscope System; Karl Storz Veterinary Endoscopy, 175 Cremona
Drive, Goleta, CA, USA) with a tip diameter of 5 mm and length of
8.5 cm were used to visualize the canal in the four cadaver heads. In
the 18 live horses, the handheld otoscope containing a gas-sterilized
plastic 7-mm otoscope cone was introduced into the external ear
canal of each horse. Each ear examined was determined to be normal
in appearance before proceeding. An attempt to pass the cone into
the proximal portion of the ear canal as atraumatically and aseptically
as possible was made. In those horses where visible cerumen was

176

Visualization of the ear canal and sample collection

The ears from four cadaver heads were examined with
handheld and video otoscopes. In those ears with small
amounts of cerumen in the proximal canal, the tympanic
membrane could be visualized using the video otoscope.
It was frequently necessary to flush the ear with normal
saline through the video otoscope port to achieve optimal
images. Some ears had accumulations of cerumen, as
well as wood shavings from bedding, in the osseous
external acoustic meatus adjacent to the tympanic
membrane. The lighting and magnification provided by

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Examination of equine ear

Figure 1. Photo: Adult horse, cross-section at the level of the left

proximal ear canal and tympanic membrane. The junction of the
cartilaginous (pigmented) and osseous (nonpigmented) portions of
the external ear where the canal narrows significantly is apparent. SC:
spiral canal, cer: cerebellum, CN V: cranial nerve V, O: occipital bone,
GP: guttural pouch, BS: basisphenoid bone, B: tympanic bullae, P:
petrous temporal bone, TM: tympanic membrane, E: external ear canal.

Figure 2. Photo: Adult horse, right ear canal. Junction of the

cartilagenous (pigmented) and osseous (nonpigmented) portion of
the equine external ear canal as visualized with a video otoscope.

the video otoscope were necessary as neither the handheld nor video otoscope could reach deep enough into the
canal to allow adequate visualization without it. The canal
narrowed significantly at the junction of the cartilaginous
and osseous portions of the external acoustic meatus and
prevented both instruments from reaching the tympanic
membrane (Fig. 1). This junction was grossly identifiable
by the abrupt change from pigmented to nonpigmented
epithelium (Fig. 2). It was possible to visualize adequately
the semitransparent tympanic membrane and the stria
mallearis where the manubrium of the malleus attaches to
the medial surface (Fig. 3).
A total of 21 ears from 18 horses were evaluated
otoscopically and samples for cytology and culture were
collected. No horses suffered damage or subsequently
developed clinical signs of ear disease following collection
of samples from the external ear canals. The procedure

Figure 3. Photo: Adult horse, right ear canal. A video otoscopic image
of the tympanic membrane of the horse.

was well tolerated but sedation supplemented with twitch

restraint was necessary to allow visualization and sample
collection from the proximal portion of the canal. The desired
landmark was the obvious junction between pigmented
(cartilagenous external acoustic meatus) and nonpigmented
canal (osseous portion of external acoustic meatus) that
occurs distal to the tympanic membrane. An attempt to
consistently sample the nonpigmented area adjacent
to the tympanic membrane was made. In all 18 horses, the
tympanic membrane could not be adequately visualized
through the handheld otoscope due to the length of the
canal and presence of copious cerumen as well as the
minimal magnification provided by the instrument.
Cytology
Eleven of the 21 samples (52%) were negative for cells
and organisms on cytology. Ten of the 21 samples (48%)
contained few to moderate numbers of epithelial cells,
many containing melanin pigment granules. One sample
(4.7%) contained low numbers (010 per HPF) of diplococci and rods. Two samples (9.5%) contained Malassezia
sp. on cytology, one had low numbers (02 per HPF) while
the other had too numerous to count. One cytology sample
contained many red blood cells likely due to iatrogenic
trauma during collection of the samples.
Bacterial cultures
Bacteria were isolated from 12 ears of 11 horses. Cultures
from nine of the 21 ears (43%) were sterile. Corynebacterium
sp. was the most frequent bacteria isolated. In only one case
was it in pure culture with more than 50 colonies isolated.
Culture from one ear yielded 100 colonies of Staphylococcus
intermedius. The rest exhibited low numbers (< 1020
colonies each) of Corynebacterium sp., Staphylococcus
sp., Streptomyces, Bacillus and unspeciated gram negative and positive rods and gram-positive cocci. Culture of
the ear with cytological evidence of rods and cocci yielded
low numbers of Corynebacterium sp., Staphylococcus sp.
and Streptococcus sp. Cultures of the two ears with
cytological evidence of yeast were negative for growth. In
the three horses where both ears were cultured, 2/3 had
negative cultures in both ears and 1/3 grew small numbers

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SJ Sargent et al.

Figure 4. Photo: Axial CT image of the head of a 15-month-old male

Arabian foal obtained at the level of the tympanic bullae, obtained
at 3-mm collimation and 2-mm increment and displayed in a bone
window (width = 2500 HU; level = 500 HU). E: external (osseous)
acoustic meatus, P: petrous temporal bone, B: tympanic bulla,
C: cochlea, cer: cerebellum, O: basilar part of the occipital bone,
J: jugular foramen, S: stylohyoid bone, L: lateral compartment of the
guttural pouch, M: medial compartment of the guttural pouch. The
soft tissue density in the left external acoustic meatus (*) represents
fluid accumulation, likely a postmortem change, and terminated at the
level of the tympanic membrane. The tympanic membrane itself is not
visible. The gas surrounding the cerebellum is a post-mortem change.

(<20 colonies) of Corynebacterium sp. in both ears. Saprophytic fungi were isolated from four ears. These were
thought to be contaminants.
Computed Tomography
The CT images obtained from the single cadaver head
provided exquisite anatomical detail of the structures of
the external and middle ear. The tympanic bullae, petrous
temporal bones, external (osseous) acoustic meatus, stylohyoid bones, guttural pouches, as well as the external
(cartilaginous) ear canal were all clearly identified (see
Figs 4 and 5). The tympanic bullae were proportionally
small compared to other species such as carnivores and
ruminants, measuring only approximately 15 mm in
maximum diameter. The osseous acoustic meatus had an
hourglass shape, measuring 9.4 (right)9.8 (left) mm in
diameter at the lateral aspect, narrowing to 4.6 (right)4.7
(left) mm in diameter in the medial aspect and widening
slightly to 6.7 (right)6.3 (left) mm at the level of the tympanic membranes. Measurements of the length of the
osseous portion of the ear canal vary by a few tenth of
milimetre depending on the slice imaged. The maximum
length of the osseous portion of the right ear canal was
26.5 mm and the left was 25.2 mm. Measuring the entire
length of the ear canal would be difficult due to its angulation
and because it cannot be imaged in a single slice, but
rather in several contiguous slices due to its orientation.
The osseous acoustic meatus was not horizontal, but
178

Figure 5. Photo: Axial CT image of the head of a 15-month-old male

Arabian foal obtained just rostral to the level of Fig. 1. Collimation:
3 mm, increment: 2 mm, displayed in soft tissue window (width =
350 HU; level = 50 HU). Notice the hypoattenuating triangular shaped
cartilage (open arrowheads) at the articulation between the stylohyoid
bone and the lateral margin of the bulla. Notice the small amount
of hypoattenuating material in the dependent portion of the right
tympanic bulla, representing fluid, likely a post-mortem change.

rather angled in a ventromedial to dorsolateral direction,

and the cartilaginous ear canal continued laterally following
very similar angulation. The structures of the inner ear
were not clearly visible; however, the malleus and cochlea
were identified on both sides.
Histopathology
Histopathology of the proximal canal of a single cadaver
head showed an abrupt change at the level of transition
from underlying cartilagenous to osseous ear canal support. Overlying the cartilagenous portion of the canal was
a moderately thick, pigmented epithelial layer with an
irregular profile, and prominent rete ridge/peg interdigitation, hair follicles and sebaceous and tubular ceruminous
glands. The epidermis overlying the portion supported by
bone had an absence of glands, a lack of melanocytes and
the epithelium had a marked reduction in thickness and
interdigitation (Fig. 6).

Discussion
In the present study, the authors were able to visualize the
proximal external ear canal in 18 horses without evidence
of otitis using handheld otoscopy, although sedation and
manual restraint were necessary. However, the handheld
otoscope did not provide good visualization of the tympanic membrane due to inadequate magnification and
lighting. Video otoscopy would have allowed the tympanic
membrane to be examined in detail, but would have
required more sedation or general anaesthesia to be safely
performed. Although many small animal practitioners
currently have access to video otoscopy in their practices,

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Examination of equine ear

Figure 6. Photomicrograph: Adult horse, decalcified cross-section

at the junction of the cartilaginous and osseous portion of the equine
external ear canal. The epidermis overlying the osseous portion is
nonglandular and lacks melanocytes. There is marked reduction in
thickness and interdigitation of the epithelium compared with the
outer cartilaginous canal. EC: ear canal, G: glands, B: bone,
C: cartilage. H&E. Bar = 2.0 mm.

it is unlikely that equine practitioners would have this

specialized equipment. Many equine practitioners do have
access to flexible endoscopes; however, the typical endoscopes used in equine practice are 7.9 9.8 mm in diameter.1 These endoscopes are too large to enter the osseous
portion of the equine external ear canal and therefore
would provide limited visualization of the proximal canal
and tympanic membrane. Many equine surgical specialists use 4 5 mm rigid endoscopes for arthroscopy and
these endoscopes could be useful for visualization of the
proximal canal and tympanic membrane. Specialty flexible
endoscopes with a shaft diameter of only 2.9 mm and mini
rigid endoscopes of 2 2.7 mm are available. These endoscopes would be small enough to visualize the equine
tympanic membrane and may be useful for performing a
myringotomy. Unfortunately, endoscopes of this size are
uncommonly available even to veterinary specialists.
In one reference, a picture obtained via endoscopy of
the previously mentioned junction between pigmented
and nonpigmented epithelial lined canal found at the start
of the osseous part of the external acoustic meatus was
identified as the tympanic membrane.1 This may lead to
confusion as to the normal appearance of the equine
tympanic membrane. The present study confirmed that the
obvious junction between pigmented and nonpigmented
epithelial lined canal found at the start of the osseous
part of the external acoustic meatus was found in all
horses examined. However, it was necessary to bypass
this region in order to visualize the tympanic membrane.
All instruments used in this study were too large to reach
the level of the tympanic membrane. CT confirmed that
the osseous portion of the canal might narrow to 4.6 mm.
Since the video otoscope utilized in this study has a tip
diameter of 5 mm, this explains the inability to pass the
instrument to the level of the tympanic membrane. It
is possible that horses of different ages, breeds or with
larger head sizes may have larger canals as CT was only
done on a single 15-month-old Arabian colt. However, four
adult cadaver heads of different breeds and ages were

examined with the video otoscope. The otoscope seemed

to reach the same portion of the canal before meeting
resistance in all four heads leading the authors to theorize
that there is little difference in the canal size of horses of
different breeds and ages. Although the authors feel that
the manubrium of the malleus where it attaches to the
medial surface of the tympanic membrane could be seen
through the tympanic membrane using the video otoscope, it is difficult to determine the accuracy of this belief
as no pictures of the equine tympanic membrane could be
referenced.
There have been no published studies on the microbial
flora and cytology of the external ear canal in normal
horses. All but three cytology samples taken from the
proximal canal in this study were negative for organisms.
The diplococci, rods and Malassezia sp. found in these
samples were likely contaminants from the distal canal or
the environment. This is supported cytologically by the
presence of epithelial cells with melanin granules, most
likely obtained from the pigmented cartilagenous portion
of the external acoustic meatus. There have been a few
reports of Malassezia sp. being isolated from the skin
of normal horses.10,11 It is possible that Malassezia sp.
may be part of the normal microbial flora in the cerumen
commonly found in the distal canal. In hindsight, sampling
of the distal canal for cytology may have been useful in
determining whether this is the case, and as a comparison
to the samples taken from the proximal canal. However,
the purpose of this study was to assess the microbial flora
of the proximal canal.
In this study, 43% of the cultures taken from the proximal
canal were negative for organisms. Of the positive cultures,
83% had low numbers of organisms that are considered
to be normal residents and transients of equine skin and
hair or environmental contaminants,12 indicating that the
proximal canal of most normal horses may be relatively
sterile. In only two ears were large numbers of pure isolates
found. These isolates were S. intermedius and Corynebacterium sp., both of which have been isolated from the
skin and hair of normal horses.12 In comparison, multiple
studies have looked at the microbial flora present in the
ear canals of normal dogs. The most commonly isolated
organisms in the dog include Staphylococcus sp. and
Malassezia sp. with 47.6% and 37.9% isolated, respectively, in one study.13 Environmental organisms are likely
to contaminate the hairs of the external pinna, as well as
the distal ear canal, due to the environment in which the
horse lives. Because of the difficulty in sampling the proximal canal in live horses, it is possible that those ears with
positive cultures were due to contamination from the distal
canal or the environment during the sampling process.
While otitis externa was possible in these horses, it is
unlikely due to the lack of clinical and cytological evidence.
Cultures were not obtained from the distal canal for comparison due to the difficulty in interpreting results that
would likely contain a large amount of organisms from the
environment.
The origin of the infectious process of otitis media is
presently unknown. Extension from otitis externa and
tympanic membrane rupture as occurs commonly in the dog13
is considered to be unlikely in the horse. Haematogenous
spread of bacteria to the inner ear is highly suspected.14

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SJ Sargent et al.

Since the guttural pouch is an outpouching of the

mucosal lining of the auditory tube seen only in the
equine,15 guttural pouch infections have been implicated
as an initiating cause.14 However, otitis media has rarely
been associated with concurrent guttural pouch infection,
and microorganisms isolated from the guttural pouch in
one study did not correlate with microorganisms obtained
from the middle ear of normal horses.7 In the same study,
organisms isolated from the middle ear of recently euthanized horses not affected by neurological disease included
Actinobacillus, Salmonella, Enterobacter, Pseudomonas,
Streptococcus, Staphylococcus and Aspergillus. With the
exception of S. intermedius and Streptococcus sp., different bacteria were isolated from the proximal ear canals
of the normal horses in the present study. The middle ears
were not sampled in the present study; therefore, populations
of bacteria cannot be compared.
The external acoustic meatus is described as having
both distal cartilagenous and proximal osseous portions.15
In carnivores and pigs, the cartilagenous part is relatively
long and curved with its initial part directed downward
(vertical canal), followed by a horizontal part that is
directed medially (horizontal canal). The osseous part of
the external acoustic meatus in these species is relatively
short and found at the level of the tympanic membrane.15
Descriptions of the cartilagenous portion of the canal in
the horse could not be found. In the present study, utilizing
cross sections of a gross specimen and CT, the cartilagenous part was found to have a gradual slope in a dorsolateral to ventromedial direction. This slope was continued
in the osseous portion of the canal, which was considerably longer than in carnivores, measuring up to 26.5 mm
on the right and 25.2 mm on the left. Unlike carnivores, a
distinct vertical and horizontal canal was not found. These
differences need to be considered when doing an otoscopic
exam in a horse.
Changes secondary to otitis media can be identified
radiographically but only after moderate bony proliferation
has occurred.7 The exquisite anatomical detail of this
region seen on CT contributes substantially to understanding how the horses unique anatomy results in adverse
sequelae associated with otitis media.14,16 Previous reports
describing the head anatomy in the horse were carried out
using thicker slices, therefore sacrificing detail of the
middle ear,17,18 and did not focus on description of the
auricular structures. It is possible that CT may be a more
sensitive diagnostic tool in the early diagnosis of otitis
media and in the diagnosis of early changes in the temporohyoid joint before fractures and neurological disease
has occurred. Evaluation of the external and middle ear in
live horses can be carried out using CT; however, this
technique requires general anaesthesia and a dedicated
large animal table that is available only at few large referral
practices and universities. More studies of affected horses
need to be done to determine the value of this diagnostic tool.
In horses and ruminants, sebaceous and tubular ceruminous glands, which secrete cerumen, are reported to be
found only within the cartilagenous part of the external
acoustic meatus, while in carnivores, they are located
along the entire external acoustic meatus.15 This was confirmed in the present study in the single cadaver head
where histopathology was done. Histopathology was not
180

done on multiple heads due to the difficulty in sectioning

the head at the level of the tympanic membrane and the
time required for decalcification. The difference in number
and location of glands as well as the presence or absence
of melanocytes results in the abrupt transition noted
grossly at the junction of the cartilagenous and osseous
portion of the equine external ear canal. This may explain
the difference in the appearance of the epithelium of the
equine external ear canal as opposed to that of the dog
and cat. It is possible that the lack of glands as well as the
relatively sterile environment in the proximal portion of
the canal may be in part why horses do not appear to suffer
from primary otitis externa. In dogs, the species most
commonly affected by otitis externa, excessive cerumen
production by the glands lining the entire ear canal is a
common predisposing factor.13 Horses also rarely suffer
from other common primary causes of otitis externa in the
dog such as atopy and food allergy.12
In conclusion, although clinical signs of ear disease are
uncommon in the horse, otic examination may be an
important diagnostic tool. An understanding of the normal
anatomy of the equine external ear canal is necessary.
Equine practitioners should be aware that otic examination is possible and may provide important diagnostic
information.

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Rsum La ralisation dun examen otoscopique et cytologique de loreille du cheval devrait tre
bnfique dans certaines maladies comme les traumatismes faciaux, le prurit facial, lotite externe conscutive une otite moyenne, le syndrome vestibulaire, les plaques aurales et le prurit auriculaire secondaire
une parasitose. En pratique, lexamen otoscopique est rarement ralis, cause dune difficult ressentie
par le praticien pour visualiser le conduit auditif et le tympan, mais galement cause de la ncessit dune
sdation. Dans cette tude, lextrmit proximale du conduit auditif externe a t tudie avec un otoscope
chez des chevaux vivants, et avec un vidootoscope sur des cadavres. La visualisation du conduit a t possible avec lotoscope sur les chevaux tranquilliss, mais lobservation de la mebrane tympanique na t
possible quaprs anesthsie ou sdation pousse, avec le vidootoscope seulement. Les conduits auditifs
de 18 chevaux ont t prlevs pour examen cytologique, et culture arobie. Pour trois chevaux, les deux
oreilles ont t prleves. Aucune cellule ni microorganisme nont t observs pour 11/21 oreilles. 9/21
oreilles taient striles la culture bactriologique. 10/21 prsentaient une pousse de plusieurs espces
bactriennes, en faible nombre (Corynebacterium sp. Notamment). 2/21 prsentaient une pousse importante
dune seule espce (Corynebacterium sp. et Staphylococcus intermedius). Des ttes de cadavre ont t
tudis par scanner et histopathologie pour mieux comprendre lanatomie du conduit auditif externe du
cheval. Les praticiens quins doivent savoir que lexamen otoscopique est possible chez le cheval et peut
permettre dobtenir des donnes diagnostiques importantes.
Resumen El examen otoscpico y citolgico del odo equino podra ser beneficioso en enfermedades
como el trauma cranial, temblores de la cabeza, otitis externa secundaria a otitis media, enfermedad
vestibular, neoplasia auricular y prurito aural secondario a infestaciones parasitarias. En la prctica, el examen
tico en caballos raramente se realiza debido a la percepcin de la existencia de dificultades para visualizar
el canal auditorio externo equino y la membrana timpnica, as como por la necesidad de tranquilizacin con
frmacos. En este estudio, el canal auditivo externo proximal se examin en caballos vivos utilizando un
otoscopio manual y en cadveres utilizando un video otoscopio. La visualizacin del canal auditivo proximal
en caballos sedados se pudo realizar con el otoscopio manual, pero mayor sedacin o anestesia general
y un video-otoscopio fueron necesarios para obtener imagenes adecuadas de la membrana timpnica
en caballos vivos. El canal auditivo proximal de 18 caballos se examin mediante citologa y con cultivos
aerbicos. En tres caballos se tomaron muestras de ambos odos. No se observaron clulas ni organismos
en 11/ 21 odos. 9/ 21 odos fueron estriles en cultivo. 10/21 desarrollaron cultivos mixtos con bajo nmero
de organismos (Corynebacterium sp. fue el ms comn). 2/21 desarrollaron elevado crecimiento de un solo
organismo (Corynebactirum sp. y Staphylococcus sp., respectivamente). Las cabezas de los cadveres se
examinaron en seccin transversal mediante tomografa computerizada (CT) e histopatologa con el fn de
entender mejor la anatoma del canal auditivo externo equino. Los clnicos veterinarios de equinos deben
saber que el examen del odo equino es posible y puede proporcionar informacin diagnstica de importancia.
Zusammenfassung Die otoskopische Untersuchung und Zytologie des Pferdeohres wre vorteilhaft bei
Krankheiten wie Kopftrauma, Kopfschtteln, Otitis externa sekundr auf Otitis media, Vestibulrsyndrom,
aurale Neoplasie und auralem Pruritus sekundr auf Parasiten. In der Praxis werden Untersuchungen des
Ohres bei Pferden selten durchgefhrt aufgrund der anerkannten Schwierigkeit der Darstellung des equinen
ueren Gehrganges und des Trommelfells, sowie wegen der Notwendigkeit der chemischen Sedierung.
In dieser Studie wurde der uere Gehrgang bei lebenden Pferden mittels manuellem Otoskop untersucht
sowie bei Kpfen von Kadavern mittels Videootoskop. Der uere Gehrgang konnte beim sedierten Pferd
mittels manuellem Otoskop sichtbar gemacht werden, aber eine strkere Sedierung oder Vollnarkose sowie
die Verwendung eines Videootoskops waren notwendig, um das Trommelfell beim lebenden Pferd ausreichend darzustellen. Die ueren Gehrgnge von achtzehn Pferden wurden zytologisch untersucht und
unter aeroben Bedingungen kultiviert. Bei drei Pferden wurden von beiden Ohren Proben genommen.
Weder Zellen noch Organismen waren bei 11/21 Ohren bei der zytologischen Untersuchung zu sehen.
Neun/21 Ohren zeigten kein Wachstum. Zehn/21 zeigten ein gemischtes Wachstum mit einer kleinen
Anzahl an Organismen (Corynebacterium sp. war der hufigste Erreger). Zwei/21 zeigten starkes Wachstum
eines einzigen Organismus (Corynebacterium sp. bzw. Staphylokokkus intermedius). Die Kpfe von toten
Pferden wurden im Querschnitt untersucht mittels Computertomographie (CT) und histopathologisch, um
die Anatomie des ueren Gehrganges besser zu verstehen. Die Pferdepraktiker sollten sich bewut sein,
dass die Untersuchung des Ohres mglich ist und wichtige diagnostische Informationen liefern knnte.
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