Download Total ear canal ablation and bulla osteotomy (TECABO)

Total Ear canal ablation and bulla osteotomy (TECABO)
Chronic ear problems can be an ever-present issue for some dogs. Often the problem has been
going on for such a long time that there are permanent changes that have taken place in the
ear canal that mean that medical treatment is no longer able to control the problem. If this is
the case then it is possible that surgery may be able to help.
Figure 1 Normal ear canal of the dog
The normal ear canal of the dog has a vertical and a horizontal component, unlike the human ear where
there is just a horizontal canal. Because of this design material can collect at the bottom of the canal
more easily than in humans. It also means that once debris and infective material has started to collect it
can be very difficult for it to be removed.
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Figure 2 changes to the ear canal after long-term infection and inflammation
Over a long period of time the lining of the canal can thicken and this further prevents drainage and
normal air flow within the ear canal. Once this happens you are in a vicious circle of infection, which
prevents drainage, which prolongs the infection. At this stage it is unlikely that any topical medication
(drops) or systemic medication (tablets) will be able to penetrate this tissue and the infection will
persist. By this time your pet is likely to have had ongoing ear problems for many months, if not years.
Occasionally you will find unusual bacteria that have infected the ear due to the chronic infection. One
of these is called Pseudomonas. When we find these bacteria we know that the underlying problem has
been present for a long period. Unfortunately this bacteria is often resistant to antibiotics and can
potentially be zoonotic (infect humans) if they have a weakened immune system.
By the time the changes to the ear canal have become permanent surgery is the only option that can
permanently solve the problem. The TCABO is a salvage surgery. This means that we are doing this
surgery because no other treatments can work. We know that we are not going to save the pets hearing
(they will not have been able to hear normally for many months if not years) but we are doing the
surgery to remove the problem.
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Figure 3 The blue area outlines the damaged tissue that will be removed
Once this tissue has been removed the infections will usually clear immediately. Once the hair has
grown back it will be very difficult to see any difference in how the pet looks. Although it is an invasive
surgery most patients are significantly more comfortable even after a few days.
Although infections can recur this is very uncommon and most patients do very well after the surgery.
As with all surgeries there are risks and these will be explained during the consultation. Often both ears
are affected and may require surgery. Even if this has to be done the quality of life improvement that is
seen is usually quite significant and the surgery may signal the end of ear problems that have been
around for a very long time.
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