Total Ear Canal Ablation and Lateral Wall Bulla Osteotomy

Question 1

What is a total ear canal ablation and lateral wall bulla osteotomy

Answer 1

involves the removal of the entire external ear canal, and this allows inspection of the middle ear.

Question 2

when is this procedure done?`

Answer 2

This is a last resort treatment when all else has failed and there is severe irreversible changes to the ear canal

Question 3

What does a bulla osteotomy involve?

Answer 3

This involves removing the diseased lining of the middle ear and cleaning out the bulla.

Question 4

Patient Prep

Answer 4

vet will inspect the ear canal to look for an underlying cause

• ear canal should be packed with a swab to prevent prep solutions from entering into the ear canal.

Question 5

Patient Clip

Answer 5

The hair will be clipped on both sides of the pinna using a size 40 blade and extended to the ventral midline!!!! then the remaining fur is vacuumed up and the ear is lint rolled to remove finer hairs if necessary.

Question 6

Prep scrub

Answer 6

Chlorhexidine and alcohol have toxic effects on the vestibular and cochlea function. Povidone Iodine is used at a rate of 5%, no higher. If a concentration above 10% is used it affects the Auditory Brainstem Response. Povidone Iodine is safe and is the standard topical antiseptic for all aural surgery’s

Question 7

Patient positioning

Answer 7

lateral recumbency with the affected ear uppermost and flipped back so the inner concave portion is ventral.

Question 8

Instruments

Answer 8

Rongeurs, fine suction tips and a periosteal elevator.

Question 9

Post op

Answer 9

monitored for pain, wound infection, and dehiscence. It is important that the owners are educated at the time of discharge about the drain’s routine care until removal.