If you’ve got a dog with chronic ear problems, your life can become one endless slog of ear cleaning, medication, and vets appointments. In most cases, this is sufficient to stay on top of the problem, but sometimes, despite everything, the dog is permanently uncomfortable, itchy and painful, becoming more and more depressed as each month goes by. In these cases, we obviously have to do something else. That’s when surgery comes into its own, in allowing the dog to live a happy, pain-free life. Of all the ear surgeries, TECA is the most radical, but has perhaps the highest success rate.
What is it used for?
TECA surgery is mainly used for chronic ear infections, where medical treatment has been ineffective (e.g. with multi-resistant bacteria, or some underlying problem that prevents us from resolving the issue); and for tumours of the ear canal. Occasionally, it may also be necessary for managing massive trauma to the ear (e.g. very severe bites, or injuries to the middle ear).
What actually is it?
TECA is actually a shortening of the full name, which is TECA-LBO. OK, that probably didn’t help! It actually stands for Total Ear Canal Ablation with Lateral Bulla Osteotomy. What this means is that all of the dog’s outer ear canal and middle ear is removed. This way, all the diseased tissue has been completely got rid of, and there is no ear left to become infected or cancerous.
Don’t they look really odd afterwards?
Not as much as you’d think, because the ear flap (or pinna) is still there – it’s just that if you lift it up, there’s no ear hole underneath. The skin is stitched across and heals over. That said, occasionally, the ear might be held in a different position (e.g. flat rather than pricked); however, this doesn’t affect the dog’s quality of life!
Surely that means they’re deaf?
Actually, no. Hearing itself occurs in the inner ear, inside the bones of the skull (the petrous temporal bone, to be precise). All of the rest of the ear is just a funnel to direct sound to the inner ear. Now, removing that funnel does reduce the sensitivity of the inner ear (in humans, relying on bone conduction alone reduces sensitivity by 10-20 dB, although similar studies don’t seem to be available for dogs). However, it’s important to remember that the diseased outer ear was probably interfering with sound conduction anyway, and most owners don’t report a noticeable difference after surgery.
Are there any other common complications?
Around the ear there are a number of sensitive structures, and we are working with already diseased or damaged tissue. As a result, there are some fairly common complications after surgery:
- Facial nerve injury, usually resulting in a weakened or lost blink reflex in the eye on that side. This is the most common side effect, but in about half of cases it is temporary.
- Inner ear damage can occur, resulting sometimes in a permanent head tilt (which most dogs get used to fairly fast), or profound deafness (uncommonly).
- Failure of the wound to close or wound breakdown is also fairly common when dealing with infected ears; however, it is usually manageable with good post-operative care and home nursing.
The overall risk of complications ranges from 29% to a little over 50%, depending on the severity of the underlying disease and the experience of the surgeon.
Is there a less radical option?
Sometimes, yes – there is a procedure called a Lateral Wall Resection where the ear canal is opened up to allow the air to get into it, and then left open permanently. In cases where bacterial infection is the problem, this may help; however, the ear tissue is still there. In addition, it will not help deal with infections that have spread into the middle ear, or with tumours.
Is the TECA effective?
Absolutely. The best data we have suggests that a TECA cures the underlying disease in 92% of cases – which is a fantastically high success rate. Although only suitable for more severe cases, due to the risks of side effects, it is an excellent option if the dog’s discomfort cannot be controlled.
If you think your dog might benefit from ear surgery, talk to one of our vets, who will be happy to talk you through the options.