Ear Infections and Total Ear Canal Ablation in Dogs

Some dogs develop ear infections that are persistent and severely damaging to the ear canal. The ear canals can be scarred by repeated infections and become calcified, causing severe discomfort and loss of hearing. This calcification can also cause additional bacteria and fungi to get trapped behind it. In some cases, the best option is to surgically remove the ear canal. This procedure also allows the surgeon to remove infected tissue and debris from the bulla, a bubble-like cavity that sits directly in front of the eardrum.

Dogs with severe and chronic ear infections can sometimes benefit from surgery to remove the ear canal called total ear canal ablation.

Common symptoms that may indicate that your dog has an ear infection can include:

• Blood in the ear
• Brown or yellow discharge
• Cauliflowered appearance of ear canal
• Crusts or scabs on inside of the outer ear
• Hair loss around the ear
• Head shaking or head tilt
• Hearing loss
• Loss of coordination
• Odor in the ear
• Pain around the ear
• Redness in or around the ear
• Rubbing of the ear and surrounding area on the floor or furniture
• Scratching at or near the ear
• Swelling of the ear
• Unusual eye movements
• Walking in circles

Types 

There are many reasons that an ear infection can become chronic. The constant swelling caused by chronic ear infections often leaves the ear canal scarred and narrowed. This can cause severe discomfort and loss of hearing. Some of the things that can lead to chronic ear infections include:

• Congenital predisposition
• Ear mites
• Ongoing allergies
• Skin disorders
• Thyroid disease 
• Tumors or polyps inside the ear

Although this surgery is used most often in cases of chronic ear infection, it can also be employed in cases of cancer of the ear canal or to address a traumatic injury to the ear canal. Cocker Spaniels are known to occasionally develop this thickening and scarring of the ear canal, but without an actual infection present.

Not every dog who suffers from ear infections is a candidate for this radical surgery. Canines who benefit from this operation often have tried several other methods of treatment that have been unsuccessful by the time this remedy is recommended. Persistent ear infections can cause the canal to scar to the level that the ear canal becomes calcified, impeding hearing and trapping bacteria or fungi on the bulla, a bubble-like cavity that sits directly in front of the eardrum.

There are several steps that your veterinarian will want to take before starting surgery in order to protect your dog’s health. A thorough physical examination including standard blood tests and a urinalysis can help identify many of the underlying health concerns that can make anesthesia and surgery more of a risk. The ear will be tested to see if there is a current infection and if there is, a culture may be taken to determine what type of infection it is. If any pus has collected behind the eardrum, it will need to be drained prior to surgery as well. 

A CT scan may also be taken to get a better idea of the amount of narrowing that has occurred and to see if any tumor or polyps have also developed in the ear canal. Repeated ear infections can also impede the functioning of the cranial nerves, impairing the dog's ability to blink. If damage to the cranial nerves has occurred before the surgery, it is likely to be permanent, and your dog will need to have eye drops periodically applied to his eyes.

The surgery is done under anesthesia to ensure that the dog does not move and that the pain is fully managed. The area around the ear is shaved, and the ear canal is cleaned in order to prepare for the removal of the tube. Incisions will be made in the cartilage that surrounds the ear canal, and it will be removed down to the bulla. In most cases, debris has collected on the bulla and infection is often present as well. 

On rare occasions, the infection has damaged the eardrum to the point that it also has to be removed, but it is more common to have a bulla osteotomy. Bulla osteotomy is completed by opening up the bulla to remove the infected tissue. When incisions have been closed, the opening where the ear canal was will be absent, but the ear usually looks otherwise unchanged. Your pet will generally remain at the hospital at least one night after surgery and pain relievers may be prescribed for your pet to reduce both pain and swelling, both in the hospital and at home.

Prognosis after this kind of surgery is usually quite good, although there are a few types of complications to be aware of. There is a facial nerve quite near the base of the ear canal and this can get bruised during the surgery. If this occurs, your dog may be unable to close his eyes and his lips may appear droopy. In order to prevent the eyes from drying out, you will need to periodically apply eye drops until the bruising has healed. Patients with this complication usually regain the control of their face within two months. 

Swelling at the joint of the jaw that commonly causes pain and difficulty chewing usually resolves in just two weeks. Most dogs who have this surgery have severely compromised hearing before surgery, so substantial alterations in responsiveness after surgery are rare.