Total Ear Canal Ablation (TECA) and Bulla Surgery in Dogs and Cats – Vet Guide for 2025 🛠️🐶🦻

When a pet’s ear infection becomes chronic, painful, and unresponsive to medications, it's time to consider a more definitive solution. The Total Ear Canal Ablation (TECA) combined with ventral bulla osteotomy offers permanent relief by removing all diseased ear tissue. In this detailed guide, Dr Duncan Houston walks you through the what, why, and how of this life-changing surgery in 2025. 🩺

🧠 What Is TECA with Ventral Bulla Osteotomy?

This surgical procedure removes the entire vertical and horizontal ear canal and opens the tympanic bulla—a bony structure of the middle ear—to clean out chronic infection. The ear flap remains, but the canal and middle ear structures are removed and the skin is closed over the area. 🎯

📉 When Is This Surgery Necessary?

• 🦠 Infection is resistant to all antibiotics
• 🧱 Ear canal is scarred, narrowed, or mineralized
• 🧫 Persistent odor, pain, or discharge despite treatment
• 🎈 Presence of tumors or inflammatory polyps

At this stage, ear cleaning and medications are no longer effective—and the surgery becomes the only path to lasting relief. 🌅

🦴 What Is the Tympanic Bulla?

The tympanic bulla is a hollow bone behind the ear canal. In chronic cases, it's filled with pus, debris, and secretory cells. It must be opened and cleaned during surgery to prevent continued infection. Think of it as draining and disinfecting a sealed infection pocket. 🧽

📋 Pre-Surgical Preparation

1. 🖥️ CT scan or radiographs to assess the extent of ear canal disease and bulla involvement
2. 🧫 Culture of ear material to start the correct antibiotic prior to surgery
3. 🧠 Neurological assessment to evaluate facial nerve function pre-op
4. 🩸 Bloodwork and urinalysis to confirm anesthetic safety

🔪 What Happens During TECA Surgery?

Under general anesthesia, your vet will:

1. Remove the vertical and horizontal ear canals in one piece
2. Open and clean out the tympanic bulla thoroughly
3. Scrape infected bone and lining from inside the bulla
4. Flush all debris and close the surgical site
5. Place a drain if needed for post-op healing

The ear flap remains, but there will be no opening into the canal. The area heals as smooth, closed skin. 🩹

💊 Post-Surgical Care

• 🦺 E-collar to prevent scratching
• 💊 Oral antibiotics and pain medications
• 📋 Bandage care and drain management (if used)
• 🗓️ Follow-up appointments every 10–14 days until healed

⚠️ Potential Complications

1. Facial Nerve Paralysis 😐

The facial nerve runs close to the surgical area. Temporary paralysis (slack jaw, inability to blink) is common, but usually resolves within weeks. Lubricating eye gel may be used. Permanent damage occurs in ~10–15% of cases.

2. Chronic Drainage 💧

Occurs in ~5–10% of cases due to residual infected tissue, bulla lining, or salivary gland involvement. May require a second procedure.

3. Great Auricular Vessel Damage 💉

Can compromise blood supply to the ear flap, causing edge necrosis. May need trimming of damaged tissue.

4. Bleeding from Retroglenoid Vein 🩸

Not typically life-threatening but can obscure the surgical field. Managed intraoperatively.

5. Breathing Issues Post-Op 😮‍💨

Throat swelling may cause breathing difficulty. Monitoring in recovery is essential.

6. Hearing Loss 🔇

Pets often already have reduced hearing. Most adapt well post-TECA. Some hearing may still be transmitted through bone conduction.

🧫 Cholesteatoma: A Special Note

A cholesteatoma is an aggressive growth inside the bulla that destroys bone and produces discharge. It complicates surgery and increases risk of recurrence. CT imaging helps identify and plan removal. 🧠

📈 Prognosis

With proper surgical technique and follow-up, most pets experience dramatic improvement in quality of life:

• No more odor or painful cleaning
• Relief from chronic headaches or jaw pain
• Better sleep and activity levels

Some patients may retain partial hearing. Owners report their pets act happier and more energetic after recovery. 🎉

🐶 Is TECA Right for My Pet?

TECA surgery is reserved for end-stage ear disease. If your dog or cat has:

• 📆 Frequent infections with no resolution
• 🧱 Scarring, mineralization, or tumors in the canal
• 🔁 Constant need for meds or flushes with no relief

It may be time to talk with your vet or a surgical specialist about TECA. 🗣️

📲 Ask A Vet for Guidance

Thinking about TECA for your pet? Use the Ask A Vet app to:

• 📸 Share medical records or ear photos
• 🩺 Get a second opinion on CT results or culture reports
• 📋 Discuss post-op care and recovery expectations

This surgery is life-changing for pets with chronic pain. Download the Ask A Vet app and take the first step toward relief today! 🐾🧡