Influence of extreme brachycephalic conformation on perioperative complications associated with total ear canal ablation and lateral bulla osteotomy in 242 dogs (2010-2020)

Banks, C; Beever, L; Kaye, B; Foo, M; ter Haar, G; Rutherford, L

Abstract

ObjectiveTo determine the influence of extreme brachycephalic conformation on presenting signs, imaging findings, intraoperative and perioperative complications following total ear canal ablation and lateral bulla osteotomy (TECA-LBO). Study designCross-sectional retrospective study. AnimalsA total of 306 (n = 242 dogs) TECA-LBOs (extreme brachycephalic breeds [EBB] = 81, other breeds [OB] = 225). MethodsMedical records of patients undergoing TECA-LBO at a single referral institution (2010-2022) were evaluated. ResultsExtreme brachycephalic breeds most commonly presented acutely, at a younger age with oto-neurological signs (46/81, 56.8%). Chronic otitis externa without neurological signs (171/225, 76.0%) was most common in OBs. Extreme brachycephalic breeds preoperatively presented more frequently with facial nerve paresis (p = .001), vestibular syndrome (p = .001), and Horner's syndrome (p = .002) compared to OBs. On diagnostic imaging, bilateral changes (p = .038), aural masses (p = .045), para-aural abscesses (p = .011), otitis interna (p = .001), and brainstem changes (p = .001) were more common in EBBs. The apparent difference in intraoperative complication rate between EBBs (9/81, 11.1%) and OBs (12/225, 5.3%) did not reach statistical significance (p = .078). Perioperative complications occurred in 85/306 (27.8%) of TECA-LBOs with no difference in perioperative complication rate between EBBs (19/81, 23.5%) and OBs (66/225, 29.3%) (p = .586). ConclusionExtreme brachycephalic breeds are more likely to present for TECA-LBO acutely, with neurological signs and more advanced diagnostic imaging abnormalities. Intra- and perioperative complication rates did not differ between EBBs and OBs. Clinical significanceDespite being subjectively more technically challenging, TECA-LBO did not result in more surgical complications in EBBs. Reported data are useful for effectively informing clients of the specific risks of TECA-LBO surgery.

Citation

Banks, C., Beever, L., Kaye, B., Foo, M., ter Haar, G., & Rutherford, L. (2023). Influence of extreme brachycephalic conformation on perioperative complications associated with total ear canal ablation and lateral bulla osteotomy in 242 dogs (2010-2020). Veterinary Surgery, https://doi.org/10.1111/vsu.13964

• Journal Article Type: Article
• Acceptance Date: Apr 2, 2023
• Online Publication Date: May 1, 2023
• Publication Date: 2023
• Deposit Date: Feb 15, 2024
• Publicly Available Date: Feb 15, 2024
• Print ISSN: 0161-3499
• Electronic ISSN: 1532-950X
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/vsu.13964
• Keywords: CHRONIC OTITIS-EXTERNA; MIDDLE-EAR; SURGICAL-MANAGEMENT; CHOLESTEATOMA