ACCREDITED CPD - SURGERY
plasia of the lateral wall of the vertical ear canal.
The indications for a TECA-BO is severe end stage otitis
externa and media. All of these cases usually have severe
narrowing of the ear canal, which makes topical medical
treatment unsuccessful
These are cases that have failed to respond to appropriate
long term medical management:
• Have severe calcification of the cartilage of the ear canal.
• Have visible sclerosis or fluid accumulation in the tympanic bulla.
• Have severe soft tissue hyperplasia from chronic inflammation extending past the vertical canal.
• Have neoplasia of the medial vertical and horizontal ear
canal.
Severe trauma to the ear canal, or congenital malformations can often require a TECA BO when the integrity of
the ear canal is severely damaged.
Figure 1. A standard ventro-dorsal radiograph. In this patient the
right ear canal shows soft tissues opacities (white arrow) which
were diagnosed as severley inflammed tissue on biopsy. The left
ear canal (blue arrow) is normal
A high percentage of dogs with severe otitis have associated allergic skin disease. This skin disease should be
managed medically prior to resorting to surgery. The otitis
will often benefit greatly from management of the allergic
skin disease. However if there is marked mineralisation of
the ear canal, or secondary changes in the bulla then the
ear disease will eventually require surgery.
The advantages of surgery include:
• No need for continued medical treatment with successful surgery (can often negatively affect the petowner relationship)
• Relief of pain and improved quality of life for the patient
• Prevents further secondary change and damage to associated structures
The disadvantages of surgery include:
• Surgical complications such as facial nerve paralysis,
vestibular syndrome and Horner’s syndrome
• Financial cost of surgery
• Surgical complications
Complete ear work up for surgery
A complete physical examination is part of any work up to
try ascertain if there are any concurrent disease processes
that may complicate the healing of the patient or the ability to tolerate the anaesthesia and surgery. A full neurological exam should always be performed to detect any
pre-existing facial nerve or peripheral vestibular involvement. The owners should be informed of these results as
they may be present in a significant number of dogs. An
abnormal neurological examination may indicate severe
progression of the otitis or other differential diagnoses
Figure 2. Rostro-caudal skull radiograph. Arrow indicates thickening
of right tympanic bulla wall suggestive of otitis media. Arrowhead
indicates normal left tympanic bulla
Figure 3. The patient in position prior to surgery
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