When an ear infection becomes incurable due to factors like resistance, mineralization, scarring, or the presence of a tumor, Total Ear Canal Ablation (TECA) is considered. TECA involves the complete removal of the ear canal, middle ear bones, and tympanic bulla, followed by draining the middle ear. This surgical intervention aims to relieve animals from prolonged pain, odor, and the need for constant ear cleaning.
Preparing for TECA
1. Diagnostic Imaging
- Radiographs or CT scans assess the condition of the tympanic bullae, ear canals, and the presence of tumors.
- Sedation is often required for these diagnostic procedures.
2. Ear Culture
- Culturing the ear helps determine the appropriate antibiotic for effective preoperative treatment.
3. Cranial Nerve Function Assessment
- Evaluate the function of cranial nerves, especially the facial nerve controlling facial expression.
4. Blood Panel and Urinalysis
- Conduct a comprehensive blood panel and urinalysis before the surgical procedure.
TECA Procedure
1. Patient Preparation
- Shave the ears and head while the patient is under anesthesia.
- Flush the ear canal one last time to minimize bacterial contamination.
2. Ear Canal Removal
- Remove both vertical and horizontal portions of the ear canal as one intact cylinder.
- Remove middle ear bones and the eardrum.
3. Tympanic Bulla Treatment
- Open and clean the tympanic bulla, removing pus, slime, or infectious material.
- An external drain may be left in place during the healing period.
4. Closure and Bandaging
- Close the cone-shaped cavity left after ear canal removal.
- Apply bandages, prescribe oral antibiotics and pain medication.
- Use an Elizabethan collar to prevent scratching.
Potential Complications
1. Vascular and Nerve Damage
- Great auricular vasculature and facial nerve can be damaged, leading to blood supply loss or facial paralysis.
- Damage to the retroglenoid vein may cause bleeding.
2. Breathing Issues
- Swelling in the throat may cause labored breathing.
3. Chronic Drainage
- 5-10% of cases may experience chronic drainage requiring additional surgery.
- Causes include salivary gland damage, residual cells, or excessive fluid production.
4. Hearing Loss
- Hearing loss is expected, and the extent varies among individuals.
- TECA may result in further hearing loss, but some hearing may still remain.
5. Cholesteatoma
- A cholesteatoma, if present, requires careful removal during surgery to prevent ongoing drainage.
Post-TECA Results
- Results are often positive, providing relief from pain, odor, and the need for ear cleaning.
- Animals typically show increased energy after the procedure.
- Veterinary expertise is crucial for TECA, and referral to a specialist may be considered.
Understanding the potential complications and postoperative care is essential for pet owners considering TECA for their animals with end-stage ear conditions.
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