Total Ear Canal Ablation and Lateral Bulla Osteotomy (TECA-LBO) Surgery
It is a sad fact that not all cases of otitis can be dealt with medically. Otitis can be a very painful and debilitating condition and if it cannot be resolved by treating and reversing the primary and perpetuating factors, as veterinary surgeons we should offer to do whatever is needed to end the animal’s discomfort. Removal all of all the diseased and painful tissues surgically is a very successful way of ending an animal’ s pain and discomfort in these situations. This is achieved by performing a Total Ear Canal Ablation and Bulla Osteotomy (TECA-LBO). The indications for a TECA-LBO are:
- End Stage Otitis ( where there is chronic irreversible change to the ear canal which prevents resolution of the pain, discomfort, infection)
- Intractable Otitis (where although the bulk of the ear canal is not “end stage” pathological changes in the ears of the middle ear, tympanic membranes and lower ear canal prevent complete resolution of the infection and healing of all affected tissues).
- Tumours in the ear canal which cannot be dealt with by lateral wall resection or vertical canal ablation.
- For financial reasons, sometimes the cost of this surgery can be less than a prolonged course of medical therapy, which can include several general anaesthetics and video otoscopy procedures, with no guarantee of success at the outset.
I have performed over 270 Total Ear Canal Ablations since 1991 and one thing that strikes me is how it can really transform dog’s life. Some of the common comments I get back from owners when their dogs come back for suture removal after this surgery include ” my dog is like a puppy again” or “I’ve got my dog back”. The persistent pain and discomfort of living with a diseased ear canal just brings them really down, similar to a dog living with a bad mouth full of diseased teeth and gums where owners report similar radical changes in their dog’s demeanor after having a dentistry procedure/extractions.
TECA-LBO surgery is not a routine operation and there are risks attached to the procedure. This is why you should always chose a surgeon who has great experience in doing the procedure and knows exactly what their complication rate is, or you should be referred to a surgical specialist at a specialist referral centre.
The surgery involves removing the whole of the vertical and horizontal canal, the integument that is adherent to the bone at the opening of the middle ear, the ear drum and part of the lateral wall of the middle ear (the “bulla osteotomy” part of the procedure), followed by thoroughly cleaning out the middle ear and removing the diseased middle ear lining with a curette.