Total Ear Canal Ablation in Dogs

Updated November 28, 2020

Remember Fred? Not long ago I told you how he was stolen and recovered 18 months later. This is the story of what happened next.

His path led to a specialist and a procedure called TECA that increasing numbers of dogs are getting. If you have a dog prone to ear infections, you should read this. Not just so you know it’s there if you need it, but also so you can avoid it.

What Is a TECA?

TECA stands for Total Ear Canal Ablation, the surgical removal of the entire ear canal. It’s usually paired with Bulla Osteotomy, which is the opening and cleaning up of the middle ear.

TECA is a drastic solution to a drastic problem. It’s what we do when all else is lost. But that doesn’t mean it’s a bad. In fact, quite the opposite.

My strong position is that far too few dogs that need TECA ever get the chance

Which Dogs Need TECA

Dog who need TECA are those whose ears cannot be fixed in any other way.

First are what we sometimes call ‘end stage’ ears. These are external ear canals that have closed due to chronic swelling or thickening of the lining, and occasionally polyps. An old name for this was ear canker. Infections in these ears cannot easily be removed, and come back quickly.

TECA surgery appearance
A head tilt

Then there are the dogs with ear drum rupture and middle or inner ear infection. A good clue is the presence of vestibular signs. These are:

  • A head tilt
  • Nystagmus (rapid eye flicking)
  • Falling to the side or inability to stand

But even these don’t normally need TECA if the infection is treated quickly and thoroughly. Surgery is required when the infection has caused secondary changes that make it impossible to remove with medication alone. Read the other causes of vestibular signs here.

Finally there are the dogs who do not allow ear treatment, such that there is no other way to resolve an ear infection. We will always try repeated sedation and long-acting gels first, but it isn’t always possible or successful. Then it’s a choice between two imperfect outcomes: continuous pain, or radical surgery.

There are plenty of other occasions when an owner does everything right and it still leads to TECA. Here are just two examples:

  • Dogs who have already had long-standing middle ear disease when they are rescued
  • Dogs whose ear canals narrow despite diligent treatment

These dogs are unfixable and in pain until surgery. In Fred’s case, like the rescue dog, time was the enemy. By the time he was found, the standard treatments for ear infections no longer worked. The sheer amount of time he’d suffered made it almost inevitable.

If you look at his CT scan at the start, the red arrow shows solid material inside his middle ear and the yellow arrow shows how his horizontal ear canal is completely closed.

A Review Of TECA

Here’s what to know before considering TECA surgery for your dog.

  1. It’s a last resort. All other options need to be explored first, but especially ear cleaning under general anaesthesia and long term medical therapy with frequent follow up.
  2. Lateral ear wall resection, Zepp’s procedure or lateral ear canal ablation are all possible alternatives that only remove part of the ear canal. However, these are next to useless if the rest of the canal is just as bad.
  3. It’s expensive. I would estimate that TECA surgery in Australia would cost at least $4000 at a specialist but there are also some private vets who can do it well for less.
  4. Success rates are good at around 90%.
  5. The ear flap is not removed. Fred’s ear at the start and Denver’s ear below show how the result is generally quite pleasing. Most people won’t know it’s been done.
  6. Dogs probably won’t be deaf afterwards. While hearing will be muffled on the operated side, it’s probably no worse than before. If the other ear is normal, like these two dogs, they hear just fine.
  7. There are risks of facial nerve paralysis, bleeding and persistent infection but these seem low for experienced surgeons. If a dog had a pre-existing head tilt, like Denver’s, it probably won’t go away but that’s a minor concern.
  8. Recovery time is like any other canine surgery. That is, much better than us!

If you have a dog who might benefit from TECA surgery, talk to your vet about it. Ear infections are common and frustrating, but there are still other options, like referral to a veterinary dermatologist.

Then there are some dogs I see for second opinions who I immediately refer for surgical evaluation. That’s because everything else has been tried, failed, and the dog is still in pain. In the end, that’s what it’s all about.

Have something to add? Comments are welcome below and will appear within 24 hours.
By Andrew Spanner BVSc(Hons) MVetStud, a vet in Adelaide, Australia. These help topics are from a series regularly posted on email and Twitter. Subscribe via email here to never miss a story! The information provided here is not intended to be used as a substitute for going to the vet. If your pet is unwell, please seek veterinary attention.

Andrew

6 Replies to “Total Ear Canal Ablation in Dogs”

  1. I’m not certain you are still answering questions or taking comments. I have a 18 month old French Bulldog who developed vestibular symptoms (head tilt; facial paralysis). She has been evaluated by two dermatologists, CT, internal video otoscopy, culture, flush, and antibiotic treatment. The results of her tests revealed congenital malformation of the middle/inner ear. Her external ear canals have never exhibited concern. To this day, she has never had external ear canal infections or problems. Her cytology came back with resistance to everything but Chloremphenicol which she finished a 45 day oral course. Her facial paralysis resolved with ABx treatment and accupuncture (she had absent menace response). The first dermatologist recommended bilateral TECA, whereas the second dermatologist recommended a VBO. I understand this is a “surgeon” preference and not up to the discretion of the dermatologist. I just have been reading the complication rates of both procedures, reoccurrence rates, and recovery. In your opinion, should we just sway to the most extreme of bilateral TECAs? I am so torn. I have taken this past 3 months to convert all her commands to sign language, but just wondering if I am being unrealistic that she will have a good quality of life. Also, 3 months prior to the vestibular syndrome leading to the bilateral ear malformation diagnosis she was diagnosed with IVDD, so we are looking at a lot of potential surgeries which also isn’t favorable for the Frenchie breed. Thoughts?

    1. Hi Ann. My first thought is to your last comment: who is saying the Frenchie breed responds poorly to surgery?? Having dealt with the breed for 30 years, and being aware of the literature this sounds like hearsay from people trying to avoid doing the right thing. My second thought is even clearer: if there are experts in the world, we ignore them at our peril. Both a VBO (ventral bulla osteotomy) or TECA are appropriate responses, but what is not is leaving a dog in possibly high levels of pain. Yes, everyone says that they don’t appear to be in pain, but in 2021 this should fool no-one.

  2. My 10 year old dog is recommended to have TECA surgery. They said it will be around $4000. My problem is she is a large dog & I can’t see paying that much with her being 10. I need your opinion if you don’t mind.

    1. Hi Susie. It’s hard to give advice on something as individual has cost, but my views are that having a surgery like this will not be regretted. The cost is usually forgotten in time, especially with a dog at only 10 years of age who should live for another three or four years if healthy. However it’s a personal choice.

  3. I have a four week old German Shepherd puppy that started tilting his head to one side. Five days after him being on antibiotics it went away. Then three days latter he started tilting it the other way. The vet has know idea what is going on. He is now six month old. His head will be straight for two weeks, then tilts off to one side for two weeks then straight for two weeks then tilts to opposite side for two weeks then straight for to weeks. He walks, runs jumps straight even if his head is tilted and no eye movement from side to side. Now if you pick him up when his head is titled then he has issues with balance. But when his head is not tilted he is fine when you pick Jim up. Any idea what could be going on with this poor guy???

    1. Hi Anita. I’m sure your vet has had a good look inside the ears, but it’s possible the problem lies deeper within, or is found somewhere else completely. This is probably a good case for referral to a specialist, who may perform advanced imaging if the answer isn’t immediately clear. It certainly sounds serious.

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