Complete Pinnectomy in Dogs

The word 'pinnectomy' refers to the surgical removal of the external ear flap of the dog. This is derived from the words 'pinna' meaning the ear flap, and '-ectomy' meaning removal. 

This procedure is performed under general anesthesia and most commonly used to remove a malignant cancerous growth that would be in danger of spreading if it were not completely excised. 

Pinnectomy may be performed in first opinion practice and requires no specialist equipment other than standard surgical instruments. 

The dog is starved overnight in preparation for surgery and given pre-emptive pain relief. General anesthesia is induced and the hair clipped from the ear flap and the surrounding quadrant of the head. The ear canal is plugged with cotton wool and the skin prepped with surgical scrub. 

Under sterile conditions the surgeon incises the skin around the base of the ear to expose the cartilage on both sides. The blood vessels running along the margin of the ear flap are identified and ligated. The cartilage is then cut with scissors and the pinna removed. 

The surgeon then reconstructs the skin by flapping the part behind the ear over the top of the exposed edge of cartilage, and suturing it to the skin on the inner surface. The dog is woken from the anesthetic and must wear a cone to prevent self-trauma. 

Samples of tissue from the pinna are sent to the lab for analysis, to identify the type of cancer for prognostic purposes.

Pinnectomy is a relatively simple procedure that makes it possible to remove potentially worrying growths. Healing is usually uneventful and once the sutures are removed the dog leads a normal life. 

The effects of pinnectomy are permanent, as the ear flap does not regrow. In the majority of cases there is no effective alternative for the removal of a suspected malignant growth. Methods such as cryosurgery (freezing the lump) or radiotherapy may be considered, but are unlikely to offer a solid outcome. 

This is because the cancer often extends on a cellular level for several millimeters beyond the visible edge of the lesion. Thus, cancerous growth need to be removed with a margin of several centimeters of healthy tissue in order to give the best chance of complete remission. Because of the nature of the earflap, it is not possible to do this without causing the cartilage to die off. Thus, the simple and most effective answer to the original problem is pinnectomy. 

The dog must wear a cone until the sutures are removed. This prevents the dog rubbing the ear, disrupting the sutures, and causing wound breakdown. If the dog tolerates it, gentle bathing of the surgical wound with salt water, can aid healing. In addition, the dog should receive pain relief for several days post-operatively. 

The surgeon will use fine, absorbable suture material. However, it may still be necessary to snip and remove these sutures manually. In a compliant dog, it is usually possible to remove the sutures with the dog fully awake in clinic. 

Once the sutures are gone, the cone can be removed and the dog return to a normal life. 

The cost of the anesthetic depends on the size of the dog, and starts from around $99 per half hour. A pinnectomy can be expected to take less than one hour in the hands of an experienced surgeon. The actual procedure will vary in cost depending on the practice but an average of $300 is typical. In addition, there will be cost such as pain relief, with this coming in from $25 for a 10 kg dog. 

Pinnectomy is a relatively safe procedure, which carries few risks in otherwise healthy patients. Cancers such as squamous cell carcinoma can be aggressive and cause marked tissue destruction locally, so complete removal of the pinna at an early stage is prefered. 

Removing the pinna causes few problems in the long term, although it could be argued that the ear flap does play a protective role against the entry of foreign bodies into the ear canal. Therefore it is a good idea for the owner to regularly check the dog's ears for signs of irritation or infection, and get a vet check-up sooner rather than later if a problem is suspected. 

The most common cause of cancer on the ear flap is due to a combination of sun exposure and lack of protective pigment in dogs with white ears. For dogs at most risk (those with white extremities who spend time in the sun) then the owner should look at ways of protecting their dog from sun damage. 

This could include applying pet-safe sunscreen to white areas, and providing the dog with shade. In addition, it is inadvisable to spend prolonged periods of time in the full sun, especially when the sun is at its strongest in summer.