Feline inflammatory aural polyps are benign growths originating from the middle ear or auditory tube lining that cause chronic ear discharge, head shaking, and sometimes head tilt or Horner's syndrome. Surgical removal — often combined with anti-inflammatory medication — resolves signs in most cats.
Last reviewed: June 2026
What Is a Feline Aural Polyp?
A feline aural (ear) polyp is a benign, pedunculated mass arising from the mucosa of the middle ear, tympanic bulla, or auditory (Eustachian) tube. These are also called inflammatory polyps or nasopharyngeal polyps when they extend through the auditory tube into the throat. They most commonly affect young cats under 5 years, though any age can be affected. Persistent upper respiratory infections and chronic inflammation are believed to trigger abnormal mucosal proliferation, as described in Fossum's 'Small Animal Surgery'.
A retrospective study of 37 cats found that roughly 59% treated with traction-avulsion alone had no recurrence of clinical signs at long-term follow-up, and cats with nasopharyngeal polyps were nearly four times more likely to be cured by traction alone than those with aural polyps (Harvey & Goldschmidt, 2001, JSAP).
Signs of an Aural Polyp in Cats
Aural polyps can cause ear-only signs, throat signs, or both — depending on where the polyp grows.
Ear signs (most common):
- Persistent head shaking and scratching at the ear
- Foul-smelling, dark, or bloody ear discharge — chronic otitis externa that does not fully resolve with standard treatment
- Visible tissue mass in the ear canal on otoscopic examination
- Sensitivity or pain when the ear is handled
Middle ear / neurological signs:
- Head tilt toward the affected side
- Horner's syndrome — small pupil, drooping eyelid, sunken eye, and protruding third eyelid on one side (classic triad of middle ear involvement)
- Vestibular ataxia — wobbly, falling, or rolling to one side (inner ear affected)
- Facial nerve paralysis — lip droop or inability to blink
Nasopharyngeal signs (polyp extending into throat):
- Stertor — noisy, low-pitched snoring breathing through the nose
- Open-mouth breathing or gagging
- Difficulty swallowing
How Are Aural Polyps Diagnosed and Treated?
Diagnosis:
- Otoscopic examination under sedation or anesthesia reveals the polyp in the ear canal; direct oropharyngeal examination under anesthesia can reveal nasopharyngeal extension
- CT or MRI evaluates bulla involvement and guides surgical planning; CT is preferred for detailed anatomy
Treatment options:
- Traction-avulsion — the polyp stalk is grasped and avulsed under general anesthesia; simpler and less invasive, preferred for nasopharyngeal polyps with minimal bulla involvement; recurrence rate is higher (up to 50%) for aural polyps with bulla disease
- Ventral bulla osteotomy (VBO) — surgical opening of the tympanic bulla to remove the polyp at its base; recommended when CT shows significant middle ear disease; provides lower recurrence rates for aural polyps
- Post-operative prednisolone — a tapering course of corticosteroids after traction significantly reduces recurrence; studies show recurrence rates near zero with combined traction + steroid treatment versus traction alone
- Antibiotics — used perioperatively or for secondary otitis
The AAFP-AAHA Feline Life Stage Guidelines, 2021 emphasize routine physical examination including otoscopic assessment to catch ear canal abnormalities early, before neurological complications develop.
When to See a Vet
Call your vet today if:
- Your cat has been shaking its head or scratching one ear for more than a week
- You notice a persistent dark, smelly, or bloody ear discharge that has not cleared with prior treatment
- Your cat's head is tilting persistently to one side
Go to the ER immediately if:
- Your cat is rolling or falling and cannot stand or walk straight (acute vestibular signs)
- One of your cat's eyes looks smaller or has a drooping eyelid combined with head tilt (Horner's syndrome)
- Your cat is in severe distress, vocalizing, or having difficulty breathing through the nose
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Frequently Asked Questions
Are aural polyps in cats painful? Chronic ear discharge and otitis can cause significant discomfort, and cats often show pain when the ear is touched or during head shaking. Middle ear involvement can cause pain and neurological deficits. Most cats improve noticeably in comfort and behavior within days of polyp removal.
Can aural polyps in cats grow back? Yes, recurrence is possible — especially with traction-avulsion alone for polyps rooted deep in the bulla. Recurrence rates after traction alone range from approximately 30–50% for aural polyps. Adding a post-operative tapering course of prednisolone substantially reduces recurrence. Ventral bulla osteotomy combined with complete polyp removal has the lowest recurrence rate.
How much does aural polyp treatment cost? A vet exam and otoscopic assessment run $50–150. CT imaging of the skull adds $600–1,200. Traction-avulsion under general anesthesia typically costs $300–800. Ventral bulla osteotomy (surgery) runs $1,500–3,500 depending on facility and complexity. Post-operative prednisolone is inexpensive — typically $10–30 for a tapering course.
Do aural polyps affect both ears? Bilateral aural polyps are uncommon but documented. Most cats present with unilateral signs, though imaging sometimes reveals bilateral bulla changes. Any cat with unexplained bilateral ear discharge or bilateral Horner's syndrome should have both bullae assessed.
Can aural polyps be confused with ear tumors? Yes. Both polyps and neoplasms (such as ceruminous gland adenocarcinoma) can appear as masses in the ear canal. Biopsy and histopathology definitively distinguish them — polyps are inflammatory in character, not malignant. Age, CT appearance, and history can help guide the index of suspicion before biopsy.
Still Not Sure if Your Cat Needs a Vet?
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