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Aural polyp in cats

If your cat has a persistent ear discharge, head shaking, a drooping eyelid, or breathing noise, see your vet — nasopharyngeal polyps require early diagnosis and surgical treatment.

Cat

In the next 60 seconds

Do not attempt to clean deep inside the ear — you could rupture the eardrum or damage a polyp.
Gently clean visible discharge from the outer ear flap with a cotton pad moistened with a vet-approved ear cleaner.
Prevent your cat from scratching the affected ear — a soft recovery collar can help prevent self-trauma while awaiting veterinary assessment.
Book a vet appointment promptly — do not wait weeks if symptoms persist despite previous treatment.
Note exactly which signs are present: is it one or both ears? Is there noisy breathing? Any change in the eye?
If Horner's syndrome is present (droopy eyelid, raised third eyelid, small pupil), mention this specifically to your vet — it helps localise the polyp to the middle ear.

Recognise the signs

Persistent head shaking and scratching at one or both ears
Ear discharge — often dark, waxy, or purulent
Foul odour from the ear(s)
Noisy breathing — snoring, stertor (low-pitched), or stridor (high-pitched) if the polyp extends into the nasopharynx
Open-mouth breathing or difficulty swallowing if nasopharyngeal polyp is large
Horner's syndrome — a cluster of neurological signs on one side of the face including: drooping upper eyelid (ptosis), sunken eyeball (enophthalmos), small pupil (miosis), and raised third eyelid (prolapsed nictitating membrane)
Head tilt or balance problems if the middle ear is affected
Recurrent ear infections that fail to resolve with standard treatment
Most commonly seen in cats under 2 years of age, but can occur at any age

First aid steps

Do not attempt to clean deep inside the ear — you could rupture the eardrum or damage a polyp.
Gently clean visible discharge from the outer ear flap with a cotton pad moistened with a vet-approved ear cleaner.
Prevent your cat from scratching the affected ear — a soft recovery collar can help prevent self-trauma while awaiting veterinary assessment.
Book a vet appointment promptly — do not wait weeks if symptoms persist despite previous treatment.
Note exactly which signs are present: is it one or both ears? Is there noisy breathing? Any change in the eye?
If Horner's syndrome is present (droopy eyelid, raised third eyelid, small pupil), mention this specifically to your vet — it helps localise the polyp to the middle ear.

Do NOT

Do NOT poke into the ear canal with cotton buds or instruments — this can cause injury or push a polyp deeper.
Do NOT use human ear drops or over-the-counter ear treatments without veterinary advice.
Do NOT assume repeated ear infections are simply otitis externa without asking your vet to examine the middle ear — polyps are frequently missed without endoscopic or imaging examination.
Do NOT delay if your cat is showing Horner's syndrome, noisy breathing, or difficulty swallowing — these suggest the polyp is large or in a critical location.

While transporting to the vet

When to phone the vet immediately

Difficulty breathing or eating — nasopharyngeal polyp may be obstructing the airway or throat
Sudden onset of Horner's syndrome (droopy eyelid, raised third eyelid, small pupil on one side)
Rapidly worsening head tilt or loss of balance
Ear infection not responding to multiple courses of appropriate antibiotic/antifungal treatment
Visible mass protruding from the ear canal or visible at the back of the mouth

When it can usually wait

Mild head shaking or minor ear discharge in a cat that is eating, drinking, and behaving normally — still needs a vet appointment within a few days, but not same-day emergency

Common causes

Inflammatory polyps arising from the middle ear (tympanic bulla) or Eustachian tube lining — exact cause not fully understood
Thought to be linked to chronic respiratory or ear infections, possibly following herpesvirus or calicivirus infection in kittens
Genetic predisposition suspected — no single breed exclusively affected but seen more in younger domestic shorthairs
Polyps can grow into the ear canal (aural polyps), the nasopharynx behind the soft palate, or both simultaneously

What you'll need

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What the vet will need to know

How long has head shaking or discharge been present?
Has the cat had repeated ear infections previously?
Any noisy breathing, snoring, or difficulty swallowing?
Have you noticed any changes in the eye(s) — drooping lids, visible third eyelid, or a smaller pupil on one side?
Is your cat's balance or coordination affected?
Previous treatments tried and their outcome
Age of onset of symptoms

Aftercare

Treatment depends on the size and location of the polyp.
Traction-avulsion (manual pulling) through the mouth under general anaesthesia is the simplest approach for nasopharyngeal polyps — but recurrence rates are reported at 30–50%.
Ventral bulla osteotomy (VBO) — surgical opening of the tympanic bulla — removes the polyp origin and dramatically reduces recurrence. It is the gold standard for middle-ear polyps.
Horner's syndrome often persists after surgery but may resolve over weeks to months.
Post-operative care includes pain management, antibiotics if infection was present, and soft food if the throat was involved.
Follow-up appointments are essential — endoscopic recheck to confirm full removal and monitor for regrowth.
Recurrence is possible — report any return of symptoms promptly.

Prevention

No reliable prevention is known as the cause is incompletely understood.
Prompt treatment of respiratory infections in kittens (herpesvirus, calicivirus) may reduce inflammatory sequelae.
Routine ear examination at annual vet checks helps detect early changes.
Do not ignore persistent ear problems — early assessment gives the best surgical outcome.

Breed-specific notes

Nasopharyngeal polyps are most commonly reported in domestic shorthair cats under 2 years old.
No strong breed predisposition is consistently documented, though some reports suggest possible increased incidence in Persians.
Any age of cat can be affected — polyps are also seen in middle-aged and older cats.

Frequently asked questions

What is Horner's syndrome and why does it happen with aural polyps?

Horner's syndrome is a set of eye and facial signs caused by damage to the sympathetic nervous supply to the eye. In cats with aural polyps, the sympathetic nerve pathway passes through the middle ear (tympanic bulla), so a polyp growing in this space can compress the nerve. Signs include a drooping upper eyelid, a small or constricted pupil, a sunken appearance to the eye, and a raised third eyelid — all on the affected side. It is not painful but is a useful sign that tells the vet the polyp is in the middle ear.

Will my cat need surgery?

Surgical removal under general anaesthesia is the main treatment. The type of surgery — traction-avulsion (pulling the polyp out through the mouth) or ventral bulla osteotomy (opening the bony cavity of the middle ear) — depends on the polyp's location and size. VBO is more invasive but gives lower recurrence rates. Your vet will discuss the best option based on your cat's examination and imaging results.

Is an aural polyp the same as a tumour?

No — polyps are benign (non-cancerous) inflammatory growths. They do not spread to other parts of the body. However, they must be distinguished from true tumours of the ear canal, which do occur in cats (particularly in older cats). Your vet may take a sample for analysis to confirm the diagnosis.

Why does my cat's ear infection keep coming back?

Recurrent or treatment-resistant ear infections in cats are a key sign that something structural may be present — including a polyp in the middle ear that acts as a persistent source of inflammation and infection. If your cat has had three or more ear infections without a clear resolution, ask your vet to examine the middle ear, ideally with video otoscopy under sedation or anaesthesia.

How common are aural polyps in cats?

They are not rare — aural and nasopharyngeal polyps are one of the more common causes of upper respiratory signs and ear disease in young cats in the UK. They are frequently underdiagnosed because the polyp can only be seen by examining behind the soft palate or deep in the ear canal under sedation. If your cat fits the picture, ask your vet specifically about polyps.

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