Bullaosteotomy

Bullaosteotomy is a surgical opening of the tympanic bulla, a bony cavity in the dog’s middle ear, to treat chronic middle ear infections.

When Is a Bullaosteotomy Performed?

The procedure is used for therapy-resistant otitis media when conservative treatments have failed over 6–8 weeks. Typical signs: the dog holds its head tilted, shows balance disorders or scratches excessively at the affected ear.

In cases of cholesteatomas, benign tissue growths in the middle ear, bullaosteotomy is often the only effective therapy.

How Does the Surgical Procedure Work?

The vet performs the procedure under general anaesthesia. Through a skin incision behind the ear, they gain access to the tympanic bulla and open it with special drills or saws.

The diseased tissue is completely removed, and the cavity is thoroughly flushed. The procedure usually takes 45–90 minutes, depending on the severity of the disease.

What Are the Success Rates of the Operation?

In Switzerland, case series on ear canal ablation with bulla osteotomy report improvement or cure in around 85 to 93 percent of dogs with chronic otitis externa and media (Sharp 1990; Beckman 1990). The outlook is significantly poorer for cholesteatomas: in one series, symptoms recurred in 10 out of 19 operated dogs (Hardie 2008).

Hearing remains intact in most cases but may be temporarily impaired.

What complications are possible?

Nerve damage occurs in approximately 5% of procedures and can lead to permanent facial paralysis. Horner’s syndrome, a drooping eyelid, develops in 10–15% of patients but usually resolves.

Infections of the surgical wound are rare due to good blood supply in the area.

What needs to be considered during aftercare?

The first 48 hours after the procedure are critical. The dog receives painkillers and often antibiotics for 10–14 days.

Head shaking and scratching at the ear must be prevented, usually by using an Elizabethan collar. Sutures are removed after 10–12 days.

Follow-up examinations are typically scheduled after 2 weeks, 6 weeks, and 3 months to monitor the healing process.