This consultation should also address whether: Prior to surgery, the owner and clinician should determine the goals of surgery: what component of the chronic otitis will be treated by surgery and whether that component will be completely or only partially eliminated. Considering this aspect of surgery, it is apparent why a TECA/LBO has the highest success rate and best prognosis of all the surgical procedures described for treating chronic otitis.
When selecting a surgical procedure, it is important to identify whether the vertical ear canal, horizontal ear canal, or middle ear is affected, and how those areas may be impacted by a procedure that does not eliminate all the affected tissue. Prior to surgery, all primary diseases, such as adverse food reactions and atopic dermatitis, should be addressed. None of the surgical procedures eliminate diseases that target the pinna or the medial aspect of the external ear orifice therefore, clinical signs of primary ear disease that target these sites often persist following surgery. With the exception of tumor excision and polyp removal, surgery rarely eliminates all causes of chronic otitis externa. Promoting ventilation and drainage of the ear canal by removing stenotic tissue and decreasing the ear canal’s length.Removing proliferative, obstructive, neoplastic, and/or infected tissue.
Surgical management of chronic otitis typically restores the ear’s self-cleaning function by: When chronic proliferative, obstructive, or neoplastic disease affects the ear canal, the normal, “self-cleaning” function of the ear is altered. During this process, material is moved out of the horizontal and vertical canals to the outer ear orifice. Surgical Considerations Advantages of SurgeryĮars naturally clean and remove debris, excessive wax, and exfoliated cells via normal epithelialization, in which epidermal turnover moves from the horizontal to the vertical canal and then to the outer ear.