Lateral Ear Resection in Dogs – Vet Surgical Guide for Chronic Ear Infections in 2025 🐶🦻🛠️

When ear infections in dogs go from an occasional nuisance to a chronic, painful ordeal, it may be time to consider surgical options. One of the most commonly performed ear surgeries is the lateral ear resection, also known as the Zepp or LaCroix procedure. In this guide, Dr Duncan Houston explains how this surgery works, when it’s appropriate, and what owners can expect in terms of care and outcomes. 🐾🩺

📉 What Is Chronic Otitis?

Chronic ear infections (otitis) can lead to:

• 😣 Persistent discomfort and pain
• 💨 Foul odor
• 🌀 Balance issues and middle ear infections
• 📉 Hearing loss or neurological signs if left untreated

While most ear infections resolve with proper treatment, some cases become resistant or recurrent, making surgical intervention necessary. That’s where lateral ear resection can help. 🧬

🔍 Understanding the Dog’s Ear Anatomy

Dog and cat ear canals are shaped like a "J", with a vertical and horizontal segment. This design impedes drainage and ventilation—factors that contribute to chronic infections. Unlike humans, who have a horizontal-only ear canal, dogs’ vertical sections tend to trap wax and debris. This is why ear infections are more common in pets. 🦠

🛠️ What Is a Lateral Ear Resection?

This surgery removes part or all of the outer vertical ear canal to improve ventilation and cleaning access. It is a conservative surgery designed for dogs whose ears are not yet in an “end-stage” disease condition.

Two Main Techniques

• Zepp Procedure: Involves skin removal and folding down half of the ear canal to form a "drain board."
• LaCroix Procedure: Simply removes the outer vertical canal wall and reforms the opening.

Both approaches aim to reshape the ear opening so it's more like a human ear—straight and open—which promotes better air flow and easier cleaning. 🧼

📷 Visualizing the Procedure

In the Zepp method, the surgeon:

1. Makes an incision along the outside of the vertical ear canal
2. Dissects and folds down the canal wall
3. Sutures the remaining tissue to the skin to form a new, straighter ear canal opening

The LaCroix procedure skips the flap folding and simply removes the lateral portion of the vertical canal. 🧵

🩺 Post-Operative Care

• 🧴 Continued treatment of existing infections with topical/oral medications
• 🦺 Elizabethan collar (cone) for 10–14 days to prevent scratching and protect incisions
• 🧵 Suture removal after healing period

This surgery does not correct the underlying causes of infection (e.g. allergies, hormone issues), but it helps manage the symptoms by improving ear hygiene. 📉

⚠️ Important Caveats and Considerations

1. 🧠 Underlying Conditions Are Not Resolved

If the root cause is allergies or systemic disease, infections may still return. This surgery facilitates management—it doesn’t cure the condition.

2. 🔍 Assessing the Horizontal Canal

If the horizontal canal is also affected (scarring, mineralization), this surgery may be ineffective. Radiographs or advanced imaging (MRI/CT) may be needed to evaluate full canal health. 🖥️

3. 🐶 Breed Suitability

One study showed poor success in Cocker Spaniels—86.5% were surgical failures. Other breeds had better success (63%). For Spaniels, total ear canal ablation may be more appropriate. 📊

4. ⚙️ Middle Ear Disease

If vestibular signs (head tilt, imbalance) are present, a lateral ear resection won't resolve the deeper issue. In such cases, more aggressive surgery is required. 🌀

5. 🧠 Surgical Planning

Some surgeons prefer attempting lateral resection before jumping to total ablation (TECA). Others may go straight to TECA based on exam or imaging results. Discuss this with your vet surgeon in detail. 🩺

❗ Possible Complications

1. 📏 Stricture

The reshaped ear opening may scar and narrow, making medication or cleaning difficult. Revision surgery may be needed.

2. ✂️ Dehiscence

Incision breakdown due to infection or tension. If stitches fail, healing may occur by secondary intention (natural healing), which takes longer and requires continued cone use. 🧶

📌 Summary: When to Consider Lateral Ear Resection

• ✅ For dogs with chronic, non-resolving otitis where vertical canal is accessible
• ❌ Not suitable for dogs with severe canal mineralization or middle ear involvement
• ⚠️ Not a cure—underlying issues must still be managed medically

🐶 Recovery Timeline

📲 When to Contact Ask A Vet

If your dog suffers from frequent, hard-to-treat ear infections, Ask A Vet can help you assess whether surgical options like lateral ear resection are right for your pet. 🐾

• 📞 Get a second opinion from a licensed vet
• 📸 Share images and history via the Ask A Vet app
• 📋 Discuss surgical options, diagnostics, and follow-up care

Don’t let your dog suffer in silence. Download the Ask A Vet app today and get expert support for chronic ear infections—wherever you are. 🐕❤️