# Fluoroscopic guidance for bulla identification during ventral bulla osteotomy in eight French bulldogs

## TL;DR

This study shows how fluoroscopy can help identify the bulla during surgery in French bulldogs with middle ear infections.

## Contribution

The novel use of fluoroscopic guidance for bulla identification in ventral bulla osteotomy in brachycephalic breeds is described.

## Key findings

- Fluoroscopy successfully guided bulla identification in eight French bulldogs.
- Six dogs retained a head tilt post-surgery, but most showed improvement over time.
- One dog required additional surgery due to recurring otitis media.

## Abstract

To describe the technique and outcome of fluoroscopy to guide bulla identification in French bulldogs during ventral bulla osteotomy.

Medical records of eight French bulldogs with otitis media that underwent a fluoroscopic‐guided ventral bulla osteotomy between January 2020 and June 2023 were reviewed. Demographics, preoperative diagnostic findings, advanced imaging findings, surgical times, histopathology and culture results, as well as postoperative outcomes, were recorded.

Following routine dissection of the bulla, fluoroscopic imaging was used to confirm the placement of a Steinmann pin before bulla penetration. The median surgical time was 152 minutes (range: 80–210 minutes). All dogs survived to discharge. Six out of eight dogs retained an ipsilateral head tilt postoperatively. Two dogs exhibited residual vestibular ataxia at 14 days postoperatively, which improved and resolved 7 months and 2 years postoperatively respectively. One dog developed recurring otitis media, and a total ear canal ablation and lateral bulla osteotomy were recommended.

Intraoperative fluoroscopy can be used successfully to guide the identification of the bulla in ventral bulla osteotomies in brachycephalic breeds.