Subtotal ear canal ablation in 18 dogs and one cat with minimal distal ear canal pathology

Effect of empirical versus definitive antimicrobial selection on postoperative complications in dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy: 120 cases (2009-2019)

OBJECTIVE

To evaluate dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy (TECA-LBO), document antimicrobial choices, and determine relationships associated with infection-related and neurologic postoperative complications.

ANIMALS

107 client-owned dogs and 13 client-owned cats that underwent TECA-LBO.

PROCEDURES

A retrospective analysis of medicals records of dogs and cats with TECA-LBO from 2 veterinary hospitals with postoperative data for at least 6 months was performed. All information associated with the TECA-LBO surgery including follow-up was recorded. Logistic regression analyses were performed and corrected using a false discovery rate to identify significance between antimicrobial administration and other perioperative variables and the outcomes of short- and long-term neurologic and infection-related complications, need for revision surgery, and euthanasia due to recurrence of infection-related signs.

RESULTS

Intraoperative cultures were performed in 111 animals, and 95 (85.5%) had bacterial growth, with Staphylococcus spp most commonly isolated. Revision surgeries due to infection-related signs occurred in 13 of 120 (10.8%) patients. If intraoperative bacterial cultures were positive and antimicrobials were administered within 1 month of surgery, patients were 85.8% less likely to exhibit infection-related complications, whereas patients not administered antimicrobials were 10.3 times as likely to require a revision surgery. Longer durations of postoperative antimicrobial administration were associated with revision surgery and euthanasia due to infection-related signs.

CLINICAL RELEVANCE

Administration of systemic antimicrobials within the first postoperative month may be necessary to prevent complications when intraoperative cultures exhibit bacterial growth and plays a role in the successful outcome of TECA-LBO.

Partial vertical ear canal resection in two cats

CASE DESCRIPTION

An 18-year-old domestic medium-hair cat (cat 1) and a 16-year-old domestic shorthair cat (cat 2) were evaluated because of obstructive skin lesions involving the perimeter of the left external auditory canal.

CLINICAL FINDINGS

Otitis externa was present in affected ears secondary to obstructive soft tissue growths involving the outer margin of the external auditory canal and outer third of the vertical ear canal. Histologic examination of a preoperative biopsy sample revealed multiple ulcerated ceruminous gland adenomas in the affected ear of cat 1. Histologic examination of the submitted tissue from cat 2 confirmed ceruminous cystomatosis with surface colonization of yeast compatible with Malassezia spp.

TREATMENT AND OUTCOME

Both cats underwent partial resection of the upper third of the affected vertical ear canal and associated diseased skin. The incised margin of the pinna was sutured to the margin of the remaining portion of the vertical ear canal with absorbable sutures. Both cats were disease free over a 12-month (cat 1) or 10-month (cat 2) follow-up period. Cat 1 later developed a small ceruminous gland adenocarcinoma in the adjacent rostrolateral margin of the vertical ear canal 1 year after surgery; the mass was resected, and the patient was free of recurrence 4 months later.

CLINICAL RELEVANCE

Partial resection was an effective alternative to complete vertical ear canal resection for lesions involving the upper third of the vertical ear canal in these cats; the partial resection procedure was deemed simpler to perform and less traumatic to the cat. Functional and cosmetic results were excellent, with preservation of the overall anatomy of the external auditory canal.

Management of complications associated with total ear canal ablation and bulla osteotomy in dogs and cats

Total ear canal ablation combined with bulla osteotomy is a salvage procedure recommended primarily for end-stage inflammatory ear canal disease but also for neoplasia and severe traumatic injuries. Due to the complexity of the procedure and the poor exposure associated with the surgical approach, there is significant risk for a variety of complications. This review discusses intraoperative, early postoperative, and late postoperative complications reported in large retrospective studies, the causes for these complications, and recommendations about how to prevent them.

Modified ear canal ablation and lateral bulla osteotomy for management of otitis media in an alpaca

OBJECTIVE

To report surgical treatment of severe otitis media in an alpaca by a modification of a subtotal ear canal ablation and lateral bulla osteotomy technique used in dogs.

STUDY DESIGN

Case report.

ANIMALS

An 11-week-old female alpaca cria.

METHODS

The cria had a 2-week history of right otitis media, nonresponsive to medical treatment, as well as right facial nerve paralysis, and a melting corneal ulcer of the right eye. Otitis media was confirmed by computed tomography. Right subtotal ear canal ablation and lateral bulla osteotomy were performed using a modification of a technique reported in dogs.

RESULTS

There were no surgical complications and the alpaca was discharged from the hospital 5 days later. At 10 months, moderate motor function had been restored to the pinna with the ear standing partially erect. The otitis had resolved, and the alpaca was reportedly well integrated into the herd.

CONCLUSION

Subtotal ear canal ablation and lateral bulla osteotomy, a technique modified from that performed in dogs, were successful in providing complete clinical resolution of otitis media in an alpaca.