Breeds such as spaniels with long, floppy ears are particularly prone to ear problems that may require ear surgery
Can ear surgery help your dog’s ear problems? Ear problems are common in dogs with certain breeds such as spaniels being particularly prone to them. The majority of ear problems can be treated medically using various medications either as tablets or ear drops. However, in some cases problems are recurrent or do not resolve. In these cases, ear surgery in dogs can have a role and help where medical treatment has failed. The two main surgical procedures performed to help with ear disease are lateral wall resection (LWR) and total ear canal ablation (TECA).How does your vet decide if your dog will benefit from ear surgery? Fig 2: This dog has severe ear disease and requires ear surgery
Ears will need a full examination under sedation. Your vet will assess for permanent damage such as narrowing and thickening of the ear canal which make ear problems more likely to persist. They will also assess for the presence of rupture of the ear drum and middle ear infection which worsen problems too. Either x-rays or (where available) CT scans can be useful to assess the involvement of the middle ear. Your vet’s decision to perform surgery will be based on the severity of changes, duration of symptoms and response to medications.
Lateral Wall Resection
What is a lateral wall resection ear surgery (LWR)? Fig 3: This dog has had a lateral wall resection ear surgery
In this procedure, one side of the ear canal is removed to make it more open and allow better ventilation and drainage. It will not totally stop your dog developing ear problems but it makes ear infections less likely to develop and easier to treat when they do. It is only appropriate to perform this procedure when the ear canal is not yet permanently damaged or narrowed. This will often be early on for a dog that has recurrent ear problems.
Indications for LWR ear surgery
Recurrent ear problems where no permanent changes have occurred in the ear canal
Complications of LWR ear surgery
Wound breakdown is the most common complication and usually heals without further surgery
Wound infections
Failure to control ear problems
What aftercare is required following a lateral wall resection ear surgery? Most dogs need to wear a plastic collar until the wound has healed and will receive a course of antibiotics and painkillers. Dogs will usually have returned to normal within 10-14 days.
What is the outlook following a lateral wall resection ear surgery? If surgery is performed early enough in the course of ear problems, the majority of dogs will have less ear problems. However many dogs will still have some ear problems.
Total Ear Canal Ablation
What is a Total Ear Canal Ablation (TECA) ear surgery? Fig 4: This is the dog shown in Fig 2 after having a total ear canal ablation ear surgery
This is where the entire ear canal is surgically removed . It will resolve even the most severe ear problem as the whole canal is removed. This surgery is also combined with a ‘lateral bulla osteotomy’ as part of the procedure. This allows your vet to open the middle ear and remove any deeper infection or ear canal lining which, if left behind, could cause complications after surgery. Although this sounds like major surgery, the majority of dogs recover well and with good pain relief will only need one night in hospital after surgery.
Indications for TECA ear surgery
Ear canals that are irreversibly thickened and narrowed due to long standing ear problems
Severe ear infections not resolving with medical management, for example Pseudomonas infection
Cancer of the ear canal
Complications of TECA Ear surgery
Common:
Loss of hearing. Most dogs with severe ear disease have already lost much of their hearing so the change may not be as severe as expected
Wound breakdown
Wound infection
Facial nerve paralysis. This results in a loss of blinking and drooping of the lip. The change is cosmetic and usually temporary resolves over a few weeks
Bleeding. Serious bleeding is unusual and can mostly be controlled during surgery
Uncommon but more serious:
Abscess formation at the surgical site. These usually require further surgery to resolve them rather than just antibiotics. This can develop months or even years after surgery
Balance problems. This results from damage to the inner ear. It is usually temporary and will resolve over days to a few weeks but can be debilitating and prolong time in the hospital
What aftercare is required following a total ear canal ablation? Most dogs need to wear a plastic collar until the wound has healed and will receive a course of antibiotics and painkillers. Dogs will usually have returned to normal within 10-14 days.
What is the outlook following a total ear canal ablation? This procedure is very effective at resolving longstanding ear problems and most owners feel their pets benefited from surgery. Approximately 25% of dogs will have some sort of complication after surgery, but these are usually minor and temporary. Serious complications occur in less than 3% of dogs.
About Terry Emmerson
Terry is an RCVS and European Recognised Specialist in Small Animal Surgery. He is Clinical Director of Surgery at North Downs Specialist Referrals; a large multidiscipline referral hospital serving dogs and cats in the South East of England. He has been working as a specialist surgeon since 1998. Terry has wide experience of all aspects of surgery but has developed a particular interest in cancer surgery.
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