Total ear canal ablation (TECA) is indicated in patients with refractory otitis media/externa or tumor originating from ear canal/lining of the bulla.
Often, chronic ear disease leads to the development of hyperplastic tissue within the horizontal and/or vertical ear canal that prevents the ingress of topical medications as well as the egress of drainage. If inflammation is chronic and severe, mineralization of the ear canals can occur.
A total ear canal ablation couples lateral ear resection with removal of the horizontal canal allowing for the resection of all affected tissue. Most often, TECAs are accompanied by a lateral bulla osteotomy (LBO) to allow access to the debris within the bulla and removal of the epithelial lining which harbors bacteria.
The most common complication with the TECA procedure is facial nerve paralysis (lip droop and inability to close eyelid on affected side). When this occurs, it is most often transient resolving in a few weeks. Occasionally, dogs may have signs of facial nerve paralysis before surgery indicating mineralization around the facial nerve. These signs will rarely improve post-operatively because the nerve is often resected with the horizontal canal. A second potential complication is fistula or abscess formation, usually occurring months or even years after surgery. If infected epithelial tissue is left in the bulla, it can turn into an abscess that eventually makes it way toward the skin surface. This complication is an indication for re-exploration of the area to remove the offending tissue.
Owners often ask if their patient will be able to hear postoperatively. This is dependent upon damage to the bones of hearing (incus, malleus and stapes) and the tympanic membrane. Often, dogs already have compromised hearing due to the amount of tissue obstructing their ear canal(s) and it is not uncommon for the tympanic membrane to be absent. Even if the tympanic membrane is intact, it is necessary to remove it in order to access and clean out the bulla. If the bones of hearing are damaged, the ability to hear may be lost but most often, no change in the pet’s ability to hear is noticed.
The TECA is a painful procedure and appropriate intra- and post-operative analgesia is paramount. Patients should have 24-48 hours of systemic narcotics with or without a local block followed by 3-5 days of Tramadol and a non-steroidal anti-inflammatory. E-collar is mandatory for 10-14 days to prevent self-trauma to the surgery site.
Overall, the TECA procedure is an excellent way to provide animals with relief of chronic pain and owners relief of medicating their pet’s painful ear(s).
An additional source for information on TECA surgery for Otitis Externa/Media please see: