Surgical Treatment of Ear Disease
Infections and other diseases
of the ear are some of the most common ailments treated by
veterinarians. Most of the time, they are able to be treated and
controlled with medication. However, when medication becomes ineffective,
surgery must be considered.
The ear has four main parts;
pinna or (ear flap)
canal (vertical and horizontal)
tympanic cavity (or bulla)
inner ear (not pictured)
Ear Canal Disease
Moisture in the ear canal promotes
yeast and bacterial growth leading to infection, foul odor, and pain.
Hanging ear flaps, canal hair, skin allergies, parasites, tumors and birth
defects can contribute to infection. Over time, even with the most
fastidious ear care, many dogs develop chronic changes which medication
Long standing and recurrent ear infections
results in three important changes;
As a result of these changes, medical treatment
thickening of the ear canal (which
blocks the opening)
deep infection of the tympanic cavity
resistance to many common antibiotics
Surgery of the Ear Canal
When medical treatment fails,
surgery becomes the only hope for resolution of ear disease. Success
with surgery of the ear canal is as high as 92% depending on the type of
procedure, skill of the surgeon, concurrent disease, severity of ear disease,
prior ear surgery and overall health of the pet.
Four surgical procedures are available for
the treatment of ear disease;
Lateral Ear Canal Resection
Vertical Ear Canal Resection
Ventral Bulla Osteotomy
Total Ear Canal Ablation with Lateral Bulla
The appropriate procedure is chosen
based upon the severity and nature of ear disease. TECA is the
most commonly performed procedure in the case of long standing disease.
When TECA is performed, the entire ear canal is removed and the tympanic
cavity is opened and cleansed. TECA is described in further detail
Total Ear Canal Ablation with Lateral
Bulla Osteotomy (TECA)
As with any surgical procedure, general
anesthesia is required. Fortunately, risk of anesthetic complications
is rare in otherwise healthy pets, regardless of age.
Typical appearance of
the surgical site
several weeks following
in a cocker spaniel.
The likelihood of curing ear disease
with TECA is as much as 92%.
TECA involves removing the entire ear canal
from the skull, opening and cleansing the tympanic cavity.
The appearance of the surgical site
when completely healed is quite cosmetic. The skin heals with a faint
scar which cannot be seen if the ear flap hangs down.
General anesthesia is utilized for
An overnight stay in the hospital is
required so that post-operative discomfort can be controlled with injectable
Hearing is typically no worse or better
Chronic ear changes and presence of vital
structures (e.g., nerves and blood vessels) near the surgical field make
a real possibility (see below).
Complications and Risks:
Typically, after a recuperative period of
2-4 weeks, no further medication of the ear is required.
Pets are relieved of discomfort and often
feel “like young pets again”.
Pets often lose their “head shyness” which
had resulted from constant treatment and pain.
Hearing is generally unaffected.
In the case of tumors, cancer can be treated
Pets may experience the following problems
Rarely, pets experience:
infection and/or breakdown of the incision
temporary facial nerve paralysis causing
loss of blink and a drooping lip
persistent skin disease at the surgical
reoccurrence of bulla infection, draining
wounds or abscess formation
partial or complete loss of ear flap
due to disrupted circulation
vertigo; which manifests as head tilt,
incoordination and loss of appetite
permanent facial nerve paralysis causing
loss of blink and a drooping lip
massive intra-operative bleeding resulting
complications (including death) arising
Permanent facial nerve
paralysis following TECA.
Fortunately, most of the above complications
are preventable with meticulous surgical technique or are temporary and
can be resolved with post-operative care. Rarely, additional surgery
Cost of the Procedure:
Pain medication is administered orally for
several days following the procedure.
Antibiotics are administered for several weeks
based on deep bacterial culture results.
A collar is worn to prevent scratching until
sutures are removed 10-14 days after surgery.
The incision is monitored for signs of swelling,
redness or discharge and kept clean with a moist cloth if necessary.
Soft food is fed for several days to ease
pressure on the TMJ joint near the surgical site.
Activity is restricted to short leash walks.
If blink is diminished, the eye is kept lubricated
until normal function returns (typically 2-4 weeks).
This typically includes examination, pre-anesthetic
bloodwork, anesthesia, surgery, hospital care, post-operative medications,
and two follow-up examinations.
Please ask your veterinarian for a detailed
surgical estimate for your pet.
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