T-shape versus circular shape: a retrospective evaluation of intraoperative and postoperative complications in a cohort of 142 dogs undergoing TECA-LBO for end-stage otitis.

Abstract

Objectives: To report the impact of the surgical approach (T-shaped or circular incision) on intraoperative and postoperative complications associated with total ear canal ablation and lateral bulla osteotomy.

Materials and methods: Medical records of dogs that underwent total ear canal ablation and lateral bulla osteotomy with T-shaped or circular incisions between 10 referral hospitals were retrospectively reviewed. Intraoperative and postoperative complications and follow-up were analysed and compared between groups using Fisher's exact test for categorical data and the Mann-Whitney rank-sum test for numerical data, with P < 0.05 considered significant.

Results: One hundred and forty-two dogs were included, totalling 156 surgeries: 84 were performed via circular incision (O-group) and 72 with a T-shaped incision (T-group). The groups were similar for sex (P = 0.182) and body weight (P = 0.836) distribution; the T-group was older at the time of surgery (P = 0.019). Intraoperative bleeding occurred in 13/156 (8%) dogs and significantly more frequently in the O-group (P = 0.03; 11 O-group [7%], two T-group [1%]). Postoperative complication rate was 38.6% (n = 60): wound complications occurred in 31/156 (20%) dogs, more frequently in the T-group (P ≤ 0.001; eight O-group [5%], 23 T-group [15%]); postoperative facial nerve neuropathy occurred in 31/156 (20%) dogs, and weakly associated with the O-group (P = 0.045; 22 O-group [14.1%], nine T-group [5.8%]).

Clinical significance: Surgical preference may guide the choice between performing T-shaped or circular incisions during total ear canal ablation with lateral bulla osteotomy. Circular incisions were associated with a higher incidence of intraoperative haemorrhage and postoperative facial nerve neuropathy, while T-shaped incisions may increase the risk of wound complications. Most complications in both groups were minor or self-limiting.