Surgery of the external ear canal

Area of Science:

• Veterinary Surgery
• Small Animal Medicine
• Otolaryngology

Background:

• Otitis externa is a common condition in small animals, representing up to 20% of veterinary practice complaints.
• Many cases become refractory to medical management, necessitating surgical intervention.
• Advanced otitis externa can involve both medial and lateral ear canal walls, impacting treatment success.

Purpose of the Study:

• To review surgical options for managing canine otitis externa.
• To emphasize the importance of early surgical intervention.
• To guide the selection of appropriate surgical procedures based on disease extent.

Main Methods:

• Review of surgical techniques for otitis externa, including lateral wall resection, vertical ear canal ablation, and total ear canal ablation.
• Discussion of indications and contraindications for each procedure based on the anatomical involvement of the ear canal.
• Evaluation of outcomes associated with different surgical approaches.

Main Results:

• Lateral wall resection (modified Zepp procedure) is recommended early for otitis externa.
• Failure to improve is noted in 34-47% of advanced cases treated surgically when the disease involves both medial and lateral walls.
• Vertical ear canal ablation is suitable for disease limited to the vertical canal.
• Total ear canal ablation with bulla osteotomy is indicated for extensive disease involving both vertical and horizontal canals, improving drainage and reducing complications.

Conclusions:

• Early surgical intervention in otitis externa can prevent disease progression and improve outcomes.
• Appropriate selection of surgical procedures based on the extent of ear canal involvement is critical for success.
• Total ear canal ablation with bulla modification offers improved outcomes for severe cases of otitis externa.