Ear: total ear canal ablation

Introduction

• Removal of entire aural canal, ie vertical and horizontal.
• Establish temporary drainage of tympanic bullae and peri-auricular tissues.

Uses

• Chronic proliferative changes in the ear canal .
• Complete horizontal canal stenosis .
• Para-aural abscessation.
• Unremitting middle ear disease .
• Neoplastic diseases of the ear canal or bulla.
• Failed lateral or vertical resection.

Advantages

• Usually combined with lateral bulla osteotomy, eg extensive middle ear disease.
• Can be used after other unsuccessful surgical interventions, eg lateral wall resection , vertical canal ablation .

Disadvantages

• High degree of complications.
• Dog may be deaf following procedure, although if the bulla is not severely disrupted hearing may only be mildly impaired.

Requirements

Materials required

Minimum equipment

• Standard surgical kit .
• Curettes .
• Rongeurs (if combined with lateral bulla osteotomy) or hammer and chisel in some large dogs with chronic changes or Jacob's hand chuck and Steinmann pin.

Ideal equipment

• Diathermy.

Minimum consumables

• Irrigating solution.
• Polygalactin and nylon suture material.
• 1/4 in Penrose drain.

Sequelae

Complications

• Facial nerve injury: neuropraxia or paralysis.
• Wound dehiscence - can be allowed to granulate.
• Vestibular signs (may be transient).
• Chronic sinus tract development due to epithelial tissue remaining in or near bulla - requires further exploration.

Prognosis

• With care, extremely successful in resolving the most recalcitrant of chronic ear diseases.
• Up to 90% success rates reported.

Sources

Publications

• Devitt C M et al(1997) Passive drainage versus primary closure after total ear canal ablation-lateral bulla oestotomy in dogs - 59 dogs (1985-1995). Vet Surg 26 (3), 210-216.
• Buback J L et al(1996) Comparison of three methods for relief of pain after canal ablation in dogs. Vet Surg 25 (5), 380-385.
• Henderson J T (1995) Total ear canal ablation with lateral bulla osteotomy for the management of end-stage otitis in dogs. Comp Cont Ed Pract Vet 75 , 175-162.
• Smeak D D et al(1993) Total ear canal ablation and lateral bulla osteotomy for management of end-stage otitis. Semin Vet Med Surg (Small Anim) 8 (1), 30-41.
• Elkins A D (1991) Surgery of the external ear canal. Probl Vet Med 3 (2), 239-253. Review.
• Sharp N J (1990) Chronic otitis externa and otitis media treated by total ear canal ablation and ventral bulla osteotomy in thirteen dogs. Vet Surg 19 (2), 162-166.
• Beckman S L et al(1990) Total ear canal ablation combining bulla osteotomy and curretage in dogs with chronic otitis externa and media. JAVMA 196 (1), 84-90.
• Mason L K et al(1988) Total ear canal ablation combined with lateral bulla osteotomy for end-stage otitis in dogs. Results in thirty dogs. Vet Surg 17 (5), 263-268.
• Bradley R L (1988) Surgical management of otitis externa. Vet Clin North Am Small Anim Pract 18 (4), 813-819.