Surgery of the Ear

NORMAL EAR ANATOMY
There are three distinct levels of the ear: the external ear, middle ear and inner ear. The inner ear contains the vestibular apparatus (balance center) and the small bones of hearing. The middle ear or tympanic bulla is a big chamber for the resonance of sound in hearing. The external ear consists of the earflap (pinna) and the ear canal. In dogs and cats, the ear canal is initially vertical then becomes horizontal to the level of the eardrum (tympanic membrane). Due to the vertical nature of the ear canal, ear infections can be difficult to treat effectively. Some patients, particularly those dogs with floppy ears, are especially prone to chronic ear infections.

LATERAL EAR RESECTION
Often, infections in the deep portions of the ear canal can be difficult or impossible to resolve with medication alone. Surgical removal of the outermost part of the vertical (upper) ear canal, Lateral Ear Resection, opens the horizontal (lower) ear canal to allow better access for cleaning and treating. Ear canal ablation may be required in cases that remain refractory (unresponsive) to lateral ear resection.

EAR CANAL ABLATION / BULLA OSTEOTOMY
Ear Canal Ablation involves the total removal of the ear canal. This procedure is done when the ear canal is closed off either because of chronic ear infections or tumors.

Periodically, even after appropriate medical or surgical treatment for chronic ear infections, the ear canals close off. This can lead to pain when eating, when the head or ears are touched, or even just as the mouth is opened. Swelling and abscesses can also occur in the area of the ears.

In many cases, the middle ear (tympanic bulla) is also affected. Bulla Osteotomy is a procedure that opens this bulla to remove the infected material and allow drainage. This may be done from ventral (underside of neck) or lateral (at the side of the head) depending on what other ear surgical procedures are being performed at that time. Occasionally, a head tilt or balance problem can result. This may be temporary or permanent.

Before surgery, a routine blood panel is submitted to check for any other health problems. Radiographs of the head may be taken while under anesthesia to see the extent of involvement. During surgery a major nerve (facial nerve) needs to be pulled away from the area so that the total ear canal can be removed. Sometimes this nerve can be bruised or permanently injured and the eyelid will not be able to close. Eye drops are then given so that the eye does not get dry. Any of these complications can be temporary or permanent.

During surgery, a culture and biopsy are usually taken. These results will help us determine the care needed after surgery. Often a drain will be left in the ear for several days to weeks. After surgery, antibiotics are given and the ear drain may need to be flushed. Sometimes after surgery, the infection can persist or recur and an abscess can develop. This can usually be resolved with a second surgery and drain placement.

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