Total Ear Canal Ablation/Lateral Bulla Osteotomy

 

TECA-LBO surgery is recommended for end-stage otitis where permanent changes occur in the ear canal preventing resolution of the otitis and the animal is in constant discomfort, when there are  tumours in the ear canal or where the cost of medical treatment for instance is likely to exceed the cost of surgery and the client wishes to pursue the surgical option.

I  performed my first TECA-LBO in 1991  and since that time have performed the procedure  over 270 times.

Although I do not consider myself a surgical specialist, I learnt to do the procedure as I felt I should be able to offer this procedure myself to my clients without the need to refer to a surgeon.

The main risks with surgery are permanent facial nerve paralysis  and post operative draining tract formation, the latter which can take as long as 2-3 years post surgery to develop.

My best estimates of long term complications post TECA surgery since 1991 were about 3% for both facial nerve paralysis and draining tracts, however, in December 2017 I  carried out a clinical audit of the previous 6 years TECA-LBO operations since changing our practice management system, looking at the clinical records of 55 cases.   The incidence of permanent facial nerve paralysis over the previous 6 years  has been 0%  and the incidence of draining tract formation, necessitating repeat surgery to curette out the tympanic bulla was 3.6% (two cases, that fully recovered after a second surgery with 5 year follow up on both).

To read the full audit, click here

These results compare very favourably with the most recently published literature.  For instance a retrospective analysis of 133 TECAs published by  Spivack et al  in JAAHA May/June 2013   p160-168 reported an incidence of residual facial nerve paralysis of 10.5 % and Smeak’s review article in  Vet Clin Small Anim 46 (2016) 609–621 quoted  incidences of post operative draining tracts  between 2-14%.

 

TECA Before & After

 

 

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