Surgery of the external ear canal

Otitis externa may account for up to 20% of presenting complaints in small animal practice. Many of these cases are non-responsive to medical therapy and require surgical intervention. The modified Zepp procedure or lateral wall resection should be considered early in the course of the disease. Performing this procedure in advanced cases of otitis externa, which involve both the medial and lateral walls of the ear canal, is responsible for 34-47% of these cases showing no improvement. Vertical ear canal ablation is the procedure of choice when the entire vertical canal is involved but the horizontal canal is free of disease. If the disease involves both the vertical and horizontal canals, a total ear canal ablation, along with removal of the lateral aspect of the bony bulla should be performed. By removing this portion of the bulla, improved drainage is achieved, and the complication rate following total ear canal ablations is decreased.