Cocker Spaniel with chronic otitis externa causing occlusion of the eternal ear canal

Total ear canal ablation and lateral bulla osteotomy (TECA/LBO) is the surgical removal of the ear canal and a portion of the osseous bulla, which is the bony structure enclosing the middle ear. This procedure is primarily used for treatment of chronic end-stage otitis externa and media when medical treatment is no longer helpful. It is also used in the surgical treatment of tumors of the ear canal and middle ear.

Otitis is inflammation and/or infection of the ear. This can occur in any breed of dog, but the Cocker Spaniel is the most common breed. The clinical signs of otitis can be treated with topical therapies until the tissue that lines that ear canal becomes proliferative and thickened. This condition can become very painful as it progresses. Most chronic otitis cases can no longer be treated medically since the medication can no longer reach the infection (because the ear canal is occluded).

A total ear canal ablation and lateral bulla osteotomy is a highly effective procedure that provides significant relief to the patient. It is very important to remove all of the infected debris from the bulla to prevent the infection from recurring. The prognosis for elimination of pain and improvement in quality of life following TECA/LBO is excellent in most cases. Many patients have suffered with symptoms of otitis for years and the improvement is immediate and dramatic.

A common complication following TECA/LBO is facial nerve damage. The facial nerve often must be stretched or sacrificed in completely removing the infected ear canal. Facial nerve paralysis causes a droopy lip and decreased blink response on the affected side, but does not seem to bother the patient. It usually resolves with time. Eye drops may be necessary if the cornea has a tendency to get dry. Other less common complications include temporary vestibular (balance) problems, seroma formation, and long-term abscess formation if there is still infected material in the middle ear.

Many owners are concerned that their pet will no longer be able to hear after this surgery, but generally their hearing is already significantly diminished because they have severe stenosis (narrowing) of their ear canals. It has been our experience that dogs do continue to hear after this surgery although it may be muffled. Most owners report that their dogs are happier and feel better following the procedure.