SURGICAL APPROACH TO TOTAL EAR CANAL ABLATION IN A CANINE PATIENT: A CASE REPORT

Resumen

Chronic, refractory otitis externa in dogs may progress to irreversible changes in the ear canal, rendering clinical treatment insufficient and indicating total ear canal ablation with bulla osteotomy (TECA-BO). This study aimed to report a case of TECA-BO in a dog with recurrent chronic otitis, describing the clinical and diagnostic findings, surgical approach, and postoperative course. An 11-year-old neutered male German Spitz was evaluated with a history of recurrent otitis of approximately 14 months’ duration and no satisfactory response to various clinical treatments. Physical examination revealed swelling and discharge in the ear canal, associated with marked discomfort in the head region. Computed tomography showed irregular thickening and mineralization of the walls of the vertical and horizontal canals, as well as intraluminal material and changes in the tympanic bulla, consistent with advanced chronic otitis externa. Given the extent and irreversibility of the lesions, TECA-BO was performed. The patient underwent general anesthesia, with acepromazine and methadone as preanesthetic medication, induction with propofol, maintenance with sevoflurane, and an auriculotemporal nerve block with lidocaine. During the procedure, the entire ear canal was removed and osteotomy of the tympanic bulla was performed, followed by curettage and lavage with warmed saline solution. The postoperative period proceeded without clinically relevant complications, with adequate pain control and maintenance of vital parameters. After 14 days, complete healing of the surgical wound and no discomfort upon manipulation were observed. Histopathological examination revealed moderate, diffuse, hyperplastic, polypoid nodular otitis. Despite unilateral hearing loss, the patient showed clinical improvement and an improved quality of life. It is concluded that TECA-BO is an effective surgical alternative in cases of advanced chronic otitis refractory to clinical treatment, particularly when there is extensive involvement of the ear canal and tympanic bulla. Appropriate diagnosis, surgical planning, anesthetic support, and postoperative management are essential for satisfactory outcomes.