Occasionally, we see young cats who have recurrent ear infections or obstructive upper airway disease. On careful examination of some of these patients we find smooth pink polyps. These are benign growths most likely originated in the middle ear and Eustachian tube. Depending on which path the polyps take when exiting the middle ear these polyps may cause problems with the ear or the nose or both. The clinical signs vary depending locations. They may include difficulty breathing when the polyps extend into the nose or may cause chronic ear inflammation if the polyps are in the ear canal. The polyps tend to occur in younger cats but have been seen in cats as old as 15 years. The cause is unknown but infectious and congenital causes have been proposed. Cats with polyps in the nasal cavity tend to present signs of upper respiratory obstruction. These may include noisy respiration, nasal discharge, sneezing, voice changes or difficulty breathing. When the polyp extends into the ear, signs may include dark wax in the ear, head tilt, head shaking or a visible mass in the ear cannel. Signs of middle and inner ear disease may also be present. These may include head tilt, abnormal eye movements and loss of balance

Some other conditions that have clinical signs similar to polyps include:

1. Upper respiratory tract infection
2. Nasal foreign bodies
3. Nasal or ear tumors
4. External, middle or inner ear infections

Diagnosis begins with an oral and auditory examine under general anesthesia. Radiographs of the ear are needed to evaluate the tympanic bulla (part of the ear). About 84% of cats with polyps have radiographic changes in their middle ear.

Treatment options include removing the polyp only or removing the polyp and surgically opening the middle ear. When the middle ear is not involved, removal of the polyp alone may be adequate. Recurrences may occur in 11% of those removed from the Nasal-pharyngeal region and in 50 % of those removed from the ear canal. The procedure used to treat the middle ear is called a ventral bulla osteotomy. This is a major surgery. Patients needing this type of surgery are referred to a board certified surgeon who specializes in these types of procedures.

Complications can occur following either simple removal or a bulla osteotomy. One of the most common is Horner’s syndrome that results from nerve damage. The upper eye lid will be lower, the third eye lid will be visible and the pupil will be smaller. The sign usually improves in a few weeks or months. Other complications that might be seen are balance disorders and polyp re-growth.

Inflammatory polyps are a frustrating problem for cats and their owners. Removal of the polyp is necessary to resolve the clinical signs.