Effect of empirical versus definitive antimicrobial selection on postoperative complications in dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy: 120 cases (2009–2019)

Abstract

OBJECTIVE To evaluate dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy (TECA-LBO), document antimicrobial choices, and determine relationships associated with infection-related and neurologic postoperative complications. ANIMALS 107 client-owned dogs and 13 client-owned cats that underwent TECA-LBO. PROCEDURES A retrospective analysis of medicals records of dogs and cats with TECA-LBO from 2 veterinary hospitals with postoperative data for at least 6 months was performed. All information associated with the TECA-LBO surgery including follow-up was recorded. Logistic regression analyses were performed and corrected using a false discovery rate to identify significance between antimicrobial administration and other perioperative variables and the outcomes of short- and long-term neurologic and infection-related complications, need for revision surgery, and euthanasia due to recurrence of infection-related signs. RESULTS Intraoperative cultures were performed in 111 animals, and 95 (85.5%) had bacterial growth, with Staphylococcus spp most commonly isolated. Revision surgeries due to infection-related signs occurred in 13 of 120 (10.8%) patients. If intraoperative bacterial cultures were positive and antimicrobials were administered within 1 month of surgery, patients were 85.8% less likely to exhibit infection-related complications, whereas patients not administered antimicrobials were 10.3 times as likely to require a revision surgery. Longer durations of postoperative antimicrobial administration were associated with revision surgery and euthanasia due to infection-related signs. CLINICAL RELEVANCE Administration of systemic antimicrobials within the first postoperative month may be necessary to prevent complications when intraoperative cultures exhibit bacterial growth and plays a role in the successful outcome of TECA-LBO.

Refractory otitis media and otitis externa in a koala (Phascolarctos cinereus) treated with total ear canal ablation and lateral bulla osteotomy

“…8,9 In domestic species, there is a significant risk of perioperative morbidity, with complications including facial nerve paresis, hypoglossal nerve dysfunction, Horner's syndrome, vestibular disease, haemorrhage, fistula formation, and infection. 1,2,[10][11][12] As described in this case, transient facial nerve dysfunction secondary to neuropraxia is a common complication, described in 48.9% of cases in one study, 1 and comparable to historic datasets. [10][11][12] Residual deficits of the facial nerve were present in only 10.5% of cases.…”

“…Total ear canal ablation combined with lateral bulla osteotomy (TECA‐LBO) is a common salvage procedure for end stage otitis media and externa refractory to medical management, and for the surgical management of aural masses in both the cat and dog 1,2 . The technique has also been adapted and described in the alpaca ( Vicugna pacos ), 3 American bison ( Bison bison ), 4 Atlantic harbor seal ( Phocavitulina concolor ), 5 bongo ( Tragelaphus eurycerus ), 6 chinchilla ( Chinchilla lanigera ), 7 and the domestic rabbit ( Oryctolagus cuniculus ) 8,9 .…”

“…The technique has also been adapted and described in the alpaca ( Vicugna pacos ), 3 American bison ( Bison bison ), 4 Atlantic harbor seal ( Phocavitulina concolor ), 5 bongo ( Tragelaphus eurycerus ), 6 chinchilla ( Chinchilla lanigera ), 7 and the domestic rabbit ( Oryctolagus cuniculus ) 8,9 . In domestic species, there is a significant risk of perioperative morbidity, with complications including facial nerve paresis, hypoglossal nerve dysfunction, Horner's syndrome, vestibular disease, haemorrhage, fistula formation, and infection 1,2,10–12 . As described in this case, transient facial nerve dysfunction secondary to neuropraxia is a common complication, described in 48.9% of cases in one study, 1 and comparable to historic datasets 10–12 .…”

“…Total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) is a common salvage procedure for end stage otitis media and externa refractory to medical management, and for the surgical management of aural masses in both the cat and dog. 1,2 The technique has also been adapted and described in the alpaca (Vicugna pacos), 3 American bison (Bison bison), 4 Atlantic harbor seal (Phocavitulina concolor), 5 bongo (Tragelaphus eurycerus), 6 chinchilla (Chinchilla lanigera), 7 and the domestic rabbit (Oryctolagus cuniculus). 8,9 In domestic species, there is a significant risk of perioperative morbidity, with complications including facial nerve paresis, hypoglossal nerve dysfunction, Horner's syndrome, vestibular disease, haemorrhage, fistula formation, and infection.…”

Effectiveness of chlorhexidine diacetate and povidone‐iodine in antiseptic preparation of the canine external ear canal prior to total ear canal ablation with bulla osteotomy procedure: A preliminary study

“…Not surprisingly, most studies have identified incisional infections occurring in up to 10.7% of TECABO cases in the short‐ and long‐term postoperative period (Beckman et al., 1990; Guillamumot et al., 2011; Mason et al., 1988; Matthiesen & Scavelli, 1990; Sharp, 1990; Smeak & Dehoff, 1986). A more recent report followed dogs at least 6 months postoperatively and found an incidence of 24.9%; 46.2% of which required revision surgery (Folk et al., 2022).…”