Total Ear Canal Ablation

Introduction

Ear inflammation/infections can be caused by many different types of disease including grass seeds within the ear canal, parasites, allergies, hormonal disease or water-associated infection (eg after swimming or baths). In the majority of cases these diseases will resolve quickly with the correct treatment. However, some animals can develop chronic infections that persist despite repeated attempts at medical management and we can consider operating on some of these dogs if medical management is not working. Infammation within the external ear canal is called otitis externa. This can spread through the ear drum into the middle ear where it causes a different set of signs including neurological signs (otitis media).

Dogs with chronic (long standing) ear infections have persistent pain and can develop a variety of other symptoms including neurological abnormalities and abscess formation. These symptoms can be severe. Total Ear Canal Ablation (TECA) is the surgical removal of the affected ear canal so that all of the diseased tissue (and infection) can be removed from the patient. The ear “flap” remains but the infected “ear hole” is removed. The surgery is quite invasive and so medical management is usually attempted first but animals usually recovery extremely well following TECA with a dramatically improved quality of life associated with the end of their chronic ear pain. TECA is also used to remove tumours affecting the ear canal and can often enable the surgeon to remove the whole tumour with a good long term prognosis.

Symptoms

The main clinical signs of otitis externa/media include head shaking, ear scratching, odour, discharge from the ear, swelling, pain, and depression of the animal. In more severe and chronic conditions abnormal behaviour or unusual head posture (eg a tilt to one side) could be present.

Diagnosis

The investigation and diagnosis starts with a thorough history and general physical examination. Complete ear examination is necessary and this can be performed in a conscious dog if tolerated. However, full otoscopic ear examination is often not feasible in conscious patients and is best performed under general anesthesia especially if the ear canals are very narrow or if the dog is painful and doesn’t tolerate ear examination. Samples may have to be taken from the ear canal to identify what type of infection is present.

Imaging of the ear may be necessary, especially if middle ear infection is suspected. Computed Tomography (CT) is most commonly used to achieve this.

Treatment and outcome

The aim of the TECA procedure is to remove the diseased and painful ear. After surgery, our Anaesthesia team creates a pain relief plan for the recovery period. Dogs are kept comfortable and are usually able to be discharged the day after surgery. A postoperative check is usually recommended and sutures (stitches) are usually removed at 10-14 days after surgery.

The surgical procedure including any possible complications and post-operative management will be discussed with your specialist surgeon during your initial consultation. The risk of serious complication following TECA is low with the vast majority of patients experiencing a vastly improved quality of life.