Ear: lateral wall resection

Introduction

• Improve ventilation of the outer ear by resection of lateral cartilage.

Uses

• → Improve ventilation and/or drainage and so reduce need for repeated medical management in persistent otitis externa .
  Many persistent cases of otitis externa have underlying dermatological problem which must receive attention before surgical management is considered.
• → To minimize opportunity for frictional dermatoses.

Advantages

• Preservation of ear conformation.
• Preservation of hearing.
• Less invasive and complicated procedure than total ear canal ablation.

Disadvantages

• High rate of failure if remaining tissues diseased and not treated adequately. Therefore, select cases carefully.
• Does not eliminate the need for on-going/intermittent medical therapy.

Requirements

Materials required

Minimum equipment

• Standard surgical kit .

Ideal equipment

• As above, plus diathermy.

Minimum consumables

• Suture.

Sequelae

Prognosis

• This procedure alone does not completely solve all chronic ear diseases.
• Up to 40% of lateral wall resection operations result in failure or continuing ear disease - see reasons for failure.

Reasons for treatment failure

• Poor surgical technique.
• Inadequate drainboard or stenosis of orifice.
• Often due to poor candidate selection.
• Failure to control underlying cause of otitis externa.
• Existing and continuing middle ear disease .
• Irreversible change to the horizontal canal.

Sources

Publications

• Sylvestre A M (1998) Potential factors affecting the outcome of dogs with a resection of the lateral wall of the vertical ear canal. Can Vet J 39 (3), 157-160.
• Elkins A D (1991) Surgery of the external ear canal. Probl Vet Med 3 (2), 239-253.
• Gregory C R (1983) Clinical results of lateral ear resection in dogs. JAVMA 182 , 1087-1090.
• Rose W R (1978) Small animal clinical otology. Surgery 4. Resection of the lateral wall of the auditory canal. Vet Med Small Anim Clin 73 (1), 35-38.