Ear Infections in Dogs and Total Ear Canal Ablation (TECA)

AJ Debiasse, a technician in Stroudsburg, PA, contributed to this article.

Hershey, a 6 year old cocker spaniel, had been in and out of the vet for ear infections for almost all of his life. He had been treated with just about every oral antibiotic, and every type of ear medication known to man. Sadly, with little to no success. Tablets, capsules, lotions, potions— nothing worked long-term. The ear infections just kept coming back. As he became more and more uncomfortable, Hershey came to be head-shy and sometimes even aggressive when his guardians tried to administer ear medications. Eventually, the smell caused by the infection had invaded every room of the house. Something had to change.

Examining infected dog ears
Frustrated by the lack of results, Hershey’s guardians finally decided to get a second opinion, but the poor dog would not allow the veterinarian to examine his ears. The vet recommended an exam of the ears under sedation. An instrument (called an otoscope) would not even fit inside the ear canals because they had become so narrow. Years of ear infections had transformed the soft and delicate cartilage of the ear canals into a hard, painful, infected mess. Such ear canals have become calcified, which means they are full of calcium deposits.

Cocker spaniels like this often have ear infections

Treating infected dog ears
“This is end-stage ear disease” said the vet, and the only effective treatment is surgery.” He referred Hershey to yours truly, a board-certified surgeon. I recommended a Total Ear Canal Ablation or TECA. “A TECA involves removing the entire ear canal,” I explained. “The next step is to completely clean up the bulla.” The bulla is a bony “bubble” at the bottom of the ear canal. At this stage of the disease, it routinely contains pus, which needs to be removed to reach good results. A sterile swab, called a culture, will also reveal which bacteria lives there, and which antibiotic will take care of it.

Hershey’s guardians asked if there were less invasive options. “Other surgeries do exist, but they will fail in Hershey’s case. Only a TECA will take care of the entire problem. And only a TECA allows cleaning up the bulla.”

Understanding TECA to treat Hershey’s ear infection
A TECA is a challenging procedure which, like any surgery, presents some risks. The most common complication of a TECA is called facial nerve paralysis. The facial nerve is connected to multiple muscles of the face. If that nerve is damaged during surgery, the patient will lose function of several of those muscles.

The most significant consequence is the inability to blink. This causes dry eye, since the tears are no longer able to spread over the entire eye. When this happens, artificial tears need to be applied to the eye.

Other complications include a head tilt and bleeding. Veterinary surgeons work hard to avoid infection. Although surgeons strive to work in a sterile environment, it is impossible to achieve that while performing a TECA. This is especially true while cleaning out the bulla. If one tiny (and invisible) bacteria is left behind during surgery, it will fester and cause a delayed infection, weeks to months after surgery.

Hearing doesn't change much after a TECA in most patients. The ear canal is so swollen, that it has already become pretty useless to transmit sound. It seems that TECA patients can feel vibrations through the skull.

Why is a TECA important in this case?
Despite the possible risk of complications, a TECA will typically have a very positive impact on patients like Hershey, when performed by an experienced surgeon.

Hershey went home the day after surgery. He received antibiotics and pain medications for 2 weeks. He had to wear an E collar (plastic cone) around his head to prevent him from scratching the incision for 3 weeks. He also had to rest strictly for 3 weeks to protect the surgery site from any addition trauma. After 3 weeks, the incision looked great and surgery was then scheduled for the second ear.

After another 3 weeks of rest, Hershey was allowed to resume his normal activity. He clearly felt comfortable and much happier than before the surgeries. His guardians were thrilled to have their Hershey back. He regained his sweet disposition after becoming pain-free.

Questions to ask your veterinarian:

  • Could my dog, with chronic ear infections, benefit from a TECA?
  • Which surgeon do you recommend to have it treated effectively?
Reviewed on: 
Wednesday, September 28, 2016