Total Ear Canal Ablation (TECA) refers to surgery which completely excises and removes the cartilage canal leading from the external ear, down to the middle (bony) portion of the ear chamber. The bony chamber is opened and cleaned of internal infection and chronic discharge to prevent further infection. The external pinna (flappy part of the ear) is not touched by surgery and the cosmetic appearance following a TECA is extremely good, with many people being completely unaware of surgery following hair regrowth.
TECA is used to manage and potentially cure patients with severe and recurrent middle and external ear infections, which have not been responsive to oral medication and topical ear drops. Chronic ear infections, cause severe inflammation and narrowing of the ear canal. The narrowing of the ear canal prevents adequate air flow and prevents medicated drops being administered to the site of infection lower down in the ear canal and middle ear. Ear infections, as in people, are extremely painful and TECA is used to remove the canal, infection and pain.
TECA does remove the transfer of sounds waves to the inner ear via the external canal and middle ear, but in many patients the external canal and middle ear are so thickened, inflamed and full of fluid and pus that sound waves are unlikely to be transferred via this path. Hearing following TECA is likely to be of a similar or slightly lower level than that found prior to surgery, with the transfer of sounds waves via the boney tissues of the middle and inner ear only.
Possible complications associated with surgery are injury to the major (facial) nerve, wound infection and recurrent abscess or fistula formation arising from the middle boney ear chamber. The facial nerve supplies sensation and muscle function to the eyelid and face, and injury may be temporary (1-4 weeks) or permanent, requiring the long-term use of artificial tears 4-6 times daily to prevent the surface of the eye drying out and causing ulceration. Infection is generally managed by the use of antibiotics, and in severe cases, the placement of surgical drains into the wound to allow the infection to drain. Abscesses and fistula formation can occur in situations where there is deep infection in the bone of the middle ear, and these can be difficult to resolve. The risk of complications following TECA is low, and for the benefit and relief of pain for the patient, is considered a worthwhile treatment option.
Total Ear Canal Ablation (TECA) Discharge Form (PDF)