Lateral Ear Canal Resection

[sharpeiple]

We are a rescue group and we have had a 6 year old dalmation surrendered. She is purebred, perfect in every way, except that her ears are almost completely closed up due to long term infection. We are looking into the options and have stumbled across this Zepps Surgery. I'm speaking to my vet today to see if he is willing to try it, but I want more information before we commit. Has anyone here ever had it performed? Was the outcome what you had hoped?

[Wundahoo]

You need to speak with a specialist about this.

Simply doing a Zepps might not be the answer. If her problems have been long term with deep seated infection and she has very occluded canals she may need a total ablation and a bulla osteotomy, which if done by a skilled surgeon gives great results.

Deep seated long term infections can get right into the middle ear and the only way to get rid of that and the subsequent secondary complications of chronic middle ear infection and chronic unremitting pain is to remove the entire structure. Cosmetically the procedure is usually better than a Zepps and if done by a good surgeon it solves the ear problems permanently. It can give an amazing result with some owners saying that they didnt realise how much of a difference it could make to their dog. Surprisingly some dogs can actually still hear in spite of having the middle ear structures removed. It's thought that there is some transmittance of sound through the remaining soft tissues.

Radiographs and CT can give a good indication of the state of the middle ear and other structures. If she has had such severe and chronic ear infections to cause almost total occlusion of the canals then it's quite likely that she would benefit from a TECA rather than a Zepps. You may find that a Zepps will not get to the deep seated and most chronic of the infection and will not be of much use in the long term.

Here is a good link to the procedure.

http://www.veterinarypartner.com/Content.plx?P=A&A=1708

[westiemum]

Sorry to hear about your girl - sad to have such bad untreated ears that get to this point. I'm not familiar with the terms you've used but my Mac had something the same or similar.

Mac had what was referred to as a left ear ablation at the age of ten for similar reasons - chronic pseudomonas infection after years of no treatment in a notorious puppy farm. The infection became so resistant to all ABs known to man ( i even flew the last lot in from Sydney) that surgery became the only option. He had his external ear canal, ear drum, middle and and inner ear cavities on the left all completely removed and is now deaf on that side but he functions really well cuing from the other westies. Having other dogs to cue from has been really really helpful for Mac. After the surgery the surgeon told me that his middle ear cavity (and inner?) was so full of pus he didn't believe that we would ever have got on top of it clinically and it would have been incredibly painful. . So surgery was the only option and the right decision.

The surgery in Macs case was over 4 hours which is a long time and a lot of GA for a little dog. But he recovered very well (fentanyl patch, ABs and anti-inflammatories if I remember correctly and a drain). His recovery was uneventful except I think it took him some days to get over the very big GA.

A word about general vets and veterinary surgeons - unless your vet has a lot of experience with this type of surgery I would use an experienced specialist surgeon. This is long complex surgery with high risks of things going wrong (from memory like accidentally cutting the facial nerve - which for a rescue dog looking for a home would be disastrous IMO). Yes it will cost a bucket with a specialist surgeon but worth every cent IMO. I can't remember what the cost in 2009 was but I'm sure it was well over 3k. But it sounds like it will be well worth it for your dally - you'll be staggered at he difference it will make to her.

Hope that helps.

[westiemum]

Snap wundahoo and thanks for the information. I'm only familiar with Macs ablation surgery. Absolutely agree about using a specialist - I remember my vet saying he wouldn't touch this with a barge pole as its a specialist surgical job.

OP not sure where you are but if you're in SA and would like to PM me I can give you some further details.

[Rappie]

A total ear canal ablation and bulla ostectomy is the better surgery for chronic infection because they can be so deep seated. Often the structures of the ear are so damaged that even if infection is resolved, they will still be prone to infection as the self defence mechanisms have been obliterated. A lateral ear canal resection might only be of more use if there was an anatomical reason for the infections to develop and the middle ear was not involved - however most chronic otitis cases have some degree of otitis media occuring.

It's definitely a job best done by a specialist surgeon, but there may a few very skilled general practitioners around that have done several before. There are certainly risks involved regardless of who performs the surgery due to the proximity of the important neurovascular structures.

[westiemum]

Great post Rappie - that was exactly what happened with Mac. BTW I wasn't being critical of general vets - I love those at my practice. I work really well with mine and they aren't afraid to say 'I don't know' - happened recently with Macs laryngeal paralysis. I have no doubt there are some general vets who are really experienced and skilled with complex surgery. In my case with an older dog with complex needs we all felt he required a specialist - and I'm sure that was the right call.

[Rappie]

Westiemum - I didn't think you were being critical at all. I can only think of two or three non specialist surgeons that I know in some personal capacity that would even contemplate doing a TECA. They are all older vets that have done further formal training and returned to take on general practice roles that are more that of 'consulting surgeons'.

[westiemum]

Good. Its very easy to accidentally offend online so just wanted to be sure.