What is a Total Ear Canal Ablation and Lateral Bulla Osteotomy (TECA-LBO)?

TECA-LBO entails removal of the whole ear canal: from its opening on the external ear (pinna), down to the skull (TECA). The middle ear (tympanic bulla) is also opened and cleaned of any debris and diseased tissue (LBO). It is important to clean the bulla very well to avoid recurrent infections. Samples from the middle ear and ear canal may be sent to the lab to check for infection (culture and sensitivity) and the type of disease present (biopsy-histology).

The surgery is relatively invasive and painful, and patients usually need to remain in hospital receiving pain killers for one to three days. When they are discharged, they go home with pain killers and sometimes antibiotics. An Elizabethan collar (“protective cone”) will be provided to avoid interference with the surgical wound and healing. Sometimes there will be external stitches on the skin that will need to be removed about 2 weeks after the surgery at your local vet practice or at Southfields.

What are the risks?

As with any operation, there are risks with the TECA-LBO. Some of the main risks and complications are:

• Facial nerve paralysis: damage to the facial nerve that may make the side of the face droopy (as when having a stroke). It also stops the blinking and the production of tears in the eye on the operated side of the face. Facial paralysis occurs in about 13-39% of dogs. The majority of these resolve and disappear on their own. If it persists beyond 6 to 8 weeks after the surgery, then it is more likely to become permanent, which happens in 4-13% of cases. If facial paralysis is present before surgery, it is less likely to resolve following surgery. Patients with facial paralysis will require eye drops to lubricate the eye until it resolves, or life-long treatment if it becomes permanent.
• Horner’s syndrome: This is due to damage of the nerves inside the bulla (middle ear). It includes a third eyelid protrusion, smaller pupil and lower position of the upper eyelid. This syndrome is more common in cats compared to dogs. If it persists beyond 6 to 8 weeks after the surgery, it is also more likely to become permanent.
• Bleeding: Bleeding can occur in about 3-14% of cases, but very few of them are actually life-threatening or require a blood transfusion.
• Recurrent infection / abscess formation: Although rare (5-10% risk), in some cases, the infection can reappear in the future, which can happens weeks, months or even years following the surgery. It can present as a small oozing sore on the skin (fistulous tract) or swelling on the side of the face (para-aural abscess). If this happens, repeat surgery is likely to be needed.

Following TECA-LBO, patients are technically deaf on the ear that was operated on. However, very loud sounds may still be audible, and some dogs have been reported to “heart” through ground or object vibrations.

The cosmetic appearance of the ear will also be mildly different. The ear flap (pinna) may appear more dropped than before, as part of the ear cartilage will be removed during surgery. Also, there will not be any visible hole / entry to the external ear on the skin, as this will also be removed and closed.

As sometimes it is difficult to understand the amount of pain our pets can be in while suffering with ear problems, a lot of the time owners report a big improvement on their dog’s behaviour following the operation. They may become livelier and more playful as they feel much more comfortable.

Please contact to arrange a referral through your local vet if you would like to a book a consultation to discuss your pet’s ear condition with us.