TECA BO is short for Total Ear Canal Ablation and Bulla Osteotomy. There are many causes of ear infections in dogs; moisture, skin allergies, conformation (eg pendulous ears, excessive hair in the ear canal, narrow ear canal etc). Inflammation of the skin in the ear canal (otitis externa) can lead to inflammation in the middle ear (otitis media). Cats can also suffer from ear disease necessitating similar surgery. Ear disease is more common in dogs than cats and this discussion will focus on TECA BO for dogs.

In cases where the ear canal is structurally normal, a consultation with a Specialist Veterinary Dermatologist may assist in gaining control of the ear infection and any skin allergies prior to considering surgical intervention.

Many pets have been treated for ear infections for months, if not years, with systemic drugs and ear drops to manage ear and skin problems prior to surgery. A TECA BO is indicated for severe chronic cases of ear disease where there has been no improvement or ongoing recurrent ear infections, neoplasia and/or obstruction of the ear canal.

Before surgery, your vet will do a thorough physical and neurological examination. If your dog is in pain, the vet may need to sedate or anaesthetise your dog to do a thorough ear examination and to obtain a swab which tells us what antibiotic the infection is sensitive to. If possible, radiographs and a CT scan of the ears should also be performed prior to surgery.

TECA BO involves removal of the vertical and horizontal ear canal, enlarging the opening of the bulla of the middle ear and removing infected tissue from the middle ear chamber.

Surgical removal of the ear canal and cleaning of the bulla provides permanent resolution of ear infection/disease. The surgery has excellent cosmetic appearance and a very high success rate with more than 90% of owners reporting an improvement in their dogs quality of life.

Hearing impairment: Many dogs have reduced hearing capacity prior to surgery and hearing quality is reduced but not lost after TECA BO. Hearing is due to bone and air conduction and only the latter is affected after surgery.

Ear carriage: dogs with ‘upright’ ears are likely to develop a ‘floppy’ ear after surgery. Dogs with floppy or pendulous ears will not be any different.

WHAT CAN GO WRONG ?

Whilst the vast majority of procedures result in success, there are a number of potential complications that can occur. Every step possible is taken along the way to minimise the risk of complications and therefore maximise the chances of a good outcome.

Potential complications include:

• Infection; can be acute (treated with antibiotics) or chronic (failure to completely remove all infected ear tissue). In cases with infection not responsive to antibiotics a second surgery may be required.

• Bleeding; there is a risk of significant bleeding during this procedure. While all precautions are taken to prevent this from occurring, your surgeon is equipped to deal with any significant haemorrhage should it occur.

• Facial nerve paralysis; this nerve runs very close to the ear canal and if it is injured during surgery it can cause drooping of the upper lip, drooping of the eyelid and reduced blink on the affected side. These signs can be temporary (last up to 6 weeks) or permanent (very uncommon).

• Vestibular disease (balance problems, similar to vertigo in humans); the delicate organ responsible for balance is next to the hearing organ. In some severe cases, damage to the balance organ is unavoidable. These patients require more nursing and a longer hospital stay after surgery. Some may have permanent balance problems.

• Horner's Syndrome; trauma to nerves near the middle ear can cause third eyelid protrusion, drooping of the upper eyelid and constriction of the pupil on the affected side. These signs are usually temporary and do not affect quality of life.

Once a dog is confirmed as a surgical candidate and the ear is as clean as possible, a date for surgery will be arranged (please note it may take several weeks to get the ear infection under control). Most dogs are well enough to go home within 24 hours of surgery. We supply antibiotics and pain relieving drugs. Your dog will need to wear an Elizabethan collar and be kept indoors for two weeks to keep the wound clean. They can be taken outside for toileting as needed. After two weeks your dog should be fully recovered and can return to normal activity.

What you need to do BEFORE the day of surgery:

• Read the Post Surgery Care Instructions for TECA BO (link below).

• Arrange a skin and ear check, and if necessary, a pre-anaesthetic blood test, 7-10 days before surgery. If your dog has any skin lesions, a medicated body wash and antibiotics may be prescribed. If skin lesions are found on the day of surgery, this may result in the procedure being rescheduled to a later date due to the risk of infection.

• Wash your dog the weekend or day before surgery. This will reduce the time spent under anaesthesia cleaning your dog on the day of surgery.

• Consider “enrichment” for your dog in the postoperative recovery period (eg stuffed toys, sniffing games, food dispensing toys, chewing and licking time etc)

View, download or print these post surgery care instructions for TECA BO.