What is Total Ear Canal Ablation (TECA)?
A Total Ear Canal Ablation is the definitive salvage procedure for all major ear canal disease in that the entire ear canal is removed along with all the diseased contents of the middle ear. The main reason or indication for a performing a TECA is chronic, painful, non-responsive otitis externa and media (severe infections of the outer and middle ear). These patients have typically been medically managed with oral and topical antibiotics and steroid preparations for years with poor or no response. TECA is also the treatment of choice for removal of tumors contained within the ear canal. Any breed may require a TECA after chronic ear infections, but Cocker Spaniels are one of the most common breeds requiring this surgery.
Procedure
A skin incision is made around the outer part of the ear canal opening making sure to include all diseased skin. The entire ear canal is then dissected free of surrounding tissue and removed. Care is taken to protect the facial nerve during canal removal. The middle ear (osseous bulla) is opened and completely debrided (cleaned out). A drain is placed within the middle ear, which exits on the side of the neck to provide temporary drainage (1-3 days) while the surgical site heals.
Prognosis
After surgery, the operated ear is deaf; however, most patients requiring a TECA have already lost hearing in the affected ear because of long-standing disease. This procedure typically yields very good cosmetic results even though there is no longer an ear canal opening. Patients are given antibiotics for 2-6 weeks post-op to clear any residual infection. Antibiotic selection is based on culture and sensitivity results (definitive identification of the bacteria and what kills it). Complication rates are fairly low after TECA and include incisional infection, loss (temporary or permanent) of fascial nerve function (loss of eye blink function), head tilt (vertigo-like feeling), and formation of a draining tract due to leaving deep infected tissue. In general, patients have an excellent long-term prognosis. They are pain free and usually need little or no additional medical management for ear related issues.