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Postoperative Care Following Total Ear Canal Ablation

A total ear canal ablation (TECA) is performed when an animal has severe inflammatory disease of the external ear canal or when a growth, which could be cancer, is present within the ear canal or middle ear cavity. This surgery involves the complete removal of the ear canal, however in most cases the pinna or external ear "flap" remains intact.

Complications Related to Surgery

The facial nerve which controls the lips and eyelids lies adjacent to the ear canal. This nerve may sometimes become involved in the pet's disease process resulting in the inability to blink as well as a facial "droop" on the affected side. In most cases, the facial nerve can be preserved at surgery; however, even the slightest manipulation can cause temporary dysfunction. This occurs in up to 50% of animals that have this type of surgery. The good news is that this dysfunction is generally temporary, and nerve function returns within a few weeks. During this time, you will need to apply a topical lubricant in the affected eye several times daily in order to prevent damage to the cornea from drying.
Another concern following this surgery is deafness following removal of the ear canal. Most pets that need this type of surgery have ear canals that are stenotic or closed due to their disease. This means that sound waves cannot travel to the inner ear where they are transmitted to the brain to create sound. These patients hear only muffled noises (like what you would hear if you covered your ears) and vibration. The structures of the inner ear are not removed with a TECA; therefore, the ability to hear should not be affected by surgery. It is hard to predict the amount of hearing your pet will have following surgery; however, most pets seem to have the same level of hearing as before.
Finally, the inner ear is rarely interrupted at surgery. In a small number of cases (<3%), the inner ear may become inflamed from the disease process or surgical manipulation. If this occurs, your pet may experience nausea, head tilting, and circling. This complication is temporary and usually resolves within a few days; however, the head tilt may persist indefinitely.

Medication

Antibiotics given by mouth are indicated in most cases. The ear canal and middle ear cavity are often contaminated with numerous bacteria and yeast organisms. A culture is taken at the time of surgery to make certain that the antibiotic chosen is appropriate for your pet's specific infection. Even if the culture result is negative, your pet should remain on antibiotics for a minimum of 3 weeks.
This surgical procedure is significantly painful; therefore we recommend that your pet have a transdermal Fentanyl patch applied 24 hours prior to surgery. This patch contains a potent morphine-like drug that is slowly delivered through your pet's skin. This will markedly reduce the amount of pain that your pet feels after surgery and make his/her recovery much smoother. If additional pain medication is indicated, it will be given without hesitation. It is our opinion that no animal should suffer from pain that we have the ability to control.

Sutures and Bandages

External skin sutures will be placed to close the incision. These sutures should be removed in 2 weeks. You should look at the incision daily and note any discoloration or discharge. Please call our office if you are concerned.
A drain may be placed into the middle ear cavity (bulla) at surgery. If this is necessary, your pet will stay in the hospital for a few days until it is removed. While the drain is in place, your pet will have a light bandage applied to the head to prevent him/her from "playing" with their drain.