Total Ear Canal Ablation/Lateral Bulla Osteotomy
Description
Total ear canal ablation/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.
Indications
This procedure is primarily used for treatment of chronic end-stage otitis externa and media when medical treatment is not longer helpful. It is also used in the surgical treatment of tumors of the ear canal and middle ear.
Postoperative Care
Give any prescribed medications as directed. If a culture of the ear was performed, then a change in antibiotic treatment may be necessary based on the results of the ear culture.
If the ears and head were bandaged, then the bandage should be changed every 2-3 days. The bandage and/or drain will be removed when the drainage has decreased significantly, which is usually about 5 days after surgery.
Apply a warm compress to the incision twice daily for approximately ten minutes. Warm compresses should be started right away if there is no bandage or after bandage removal. If your pet is rubbing or scratching the incision, then he or she will need an Elizabethan collar designed to prevent damage to the incision line.
Observe your pet for problems, and contact us if you notice any of the following:
- Excessive swelling or drainage from the incision
- Wet, soiled, or slipped bandage
- Extreme lethargy, listlessness, or anorexia
- Extreme pain or sensitivity of the incision
Please schedule a recheck appointment every 2-3 days following surgery if a bandage is present. Please schedule an appointment for suture removal 10 to 12 days after surgery, and contact us immediately if any of the above problems are noted.
Prognosis
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. 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. Bulla osteotomy in cats often causes Horner’s syndrome (raised third eyelid and smaller pupil), which may be temporary or permanent. Horner’s syndrome does not cause any discomfort or dysfunction to the eye.
Your pet’s recovery and well-being are our primary concerns, so please do not hesitate to call and speak with a surgical technician or surgeon if there are any questions regarding your pet’s recovery.