Total ear canal ablation

The term total ear canal ablation or TECA describes a surgical procedure used to manage some severe ear diseases. It is usually only used when other methods of treatment have failed.

Surgery can be used for treatment of ear diseases such as tumors, abscesses, or for infections of the ear canal when other treatment options have failed. Cats undergoing this surgery will have had many different kinds of medical treatment for months or years with limited success. Surgery may also be indicated, to quickly resolve the issue, if an ear problem is causing severe pain and discomfort. The most common ear surgery is called a Total Ear Canal Ablation (TECA). This is a surgical procedure where all of the infected tissues in the middle and inner ear are removed leaving behind the ear flap (pinna), but no ear canal opening.

A complete workup is essential before TECA surgery is planned. Including:

• Clinical examination.
• X-rays of the skull to look for any bony changes.
• CT and/or MRI scan to help with the decision making for the surgery. CT provides information on the bony structures, whereas MRI gives a much better view of any fluid filled areas and the nerves within the ear structure.
• Neurological examination.
• Blood tests to assess kidney and liver function before anesthesia.
• Collection of a sample of material from the ear to assess what bacteria is present and what antibiotics it may be sensitive to.

A TECA surgery is carried out under a general anesthetic. The fur is clipped from one side of the head/face and neck and sometimes further down the body. If both ears are affected only one will be operated on at a time. The second surgery, on the other ear, will be performed some weeks later, depending upon how well your pet recovers from the first surgery.

The surgery involves the removal of the entire ear canal. Only the ear flap and the hearing organ inside the head are left in position. Following removal of the diseased ear canal, part of the bony wall of the tympanic bulla (middle ear) is also removed to enable the removal of infected material from the middle ear chamber.

The hearing organ itself is not removed during the TECA operation but the removal of the ear canal itself will result in some hearing loss. However, most animals having a TECA surgery will already have reduced hearing due to severe changes and thickening in the ear canal. Most owners do not notice much difference in their pet’s hearing post-operatively.

There are many possible complications from TECA surgery and these must be carefully considered before surgery. As for all surgeries there is the risk of an anesthetic itself, but in the hands of an experienced veterinary team this will be low provided your pet is otherwise fit and healthy.

The risks from the surgery itself include:

• Damage to the nerves around the face – this may be apparent for up to 2 weeks post-surgery. This can include facial nerve deficits (paralysis of the face muscles, absent or reduced blink of the eye, excessive drooling from the mouth) and vestibular signs such as head tilt/ataxia, and nystagmus (eye flicking). In some cats nerve damage causes a condition called Horner syndrome with protrusion of the third eyelid, drooping of the upper eyelid and constriction of the pupil of the eye on the operated side.
• Infection of the wound or abscess formation.
• Damage to the blood supply to the ear pinna.

A TECA is a major surgical procedure and must never be embarked upon without serious thought and commitment.

Your cat will be kept in the hospital until your veterinarian is happy that you will be able to continue their care at home. Your pet will have pain relief and antibiotics and these medications may need to be given for several weeks after surgery. Wound care is very important, and you will need to ensure the wound is kept clean and that your pet cannot interfere with it. Some form of protective collar (buster collar) or bandaging will be needed to stop your cat damaging the stitches.

For the vast majority of cats TECA surgery will provide rapid relief from what will have been months or years of pain or irritation from chronic ear disease. Around 9 in 10 owners report that their pets have a better quality of life after surgery than before. Cats will need to be kept restricted for around 2 weeks until healing is complete. After this time a normal quality of life should be resumed.

TECA surgery is a radical surgery that is used as a last resort for management of ear disease that is not improving despite medical therapy. If you are considering this treatment for your pet make sure you discuss all the pros and cons before making any decision.