Lateral Approach to Subtotal Bulla Osteotomy in Dogs Pertinent Anatomy and Procedural Details* Daniel D. Smeak, DVM, Diplomate ACVS Nongnuch Inpanbutr, DVM, MS, PhD The detail of this program is published in the: Compendium on Continuing Education for the Practicing Veterinarian Volume 27(5) May 2005 Pages 377-385 View the videos You will need Quicktime to view the videos Figures Key points Continuing Education Quiz ABSTRACT Lateral bulla osteotomy (LBO) is often performed with total ear canal ablation (TECA) to expose and debride tissue and exudate deep within the tympanic cavity. Since TECA permanently eliminates drainage from the middle ear through the external meatus, there is risk of intractable deep wound infection resulting from poor tympanic cavity debridement. Furthermore, the regional anatomy is complex and poorly exposed, and neurovascular damage during LBO can lead to acute life-threatening and/or long-standing complications. Current literature just briefly describes LBO technique, and only limited access to the tympanic cavity can be achieved as it is described. The goal of this article is to present new detailed anatomic and procedure descriptions to provide maximal tympanic cavity exposure, while avoiding complications during and after LBO in the dog. * Funded by The Ohio State University, Veterinary Alumni Society ----- The Ohio State University - You will need Quicktime to view the video clips. The videos in this section outline the sevem procedural steps to the Lateral Bulla Osteotomy. These include: - Ear Canal Ablation: Initial approach to the ear canal - Ear Canal Ablation: Soft tissue dissection to free the ear canal - Ear Canal Ablation: Facial nerve isolation, ear canal amputation - Lateral Bulla Osteotomy: Facial nerve protection, lateral bulla exposure - Lateral Bulla Osteotomy: Ventral bone slot in osseous ear canal, epithelium removal - Lateral Bulla Osteotomy: Ventrolateral tympanic bulla removal - Lateral Bulla Osteotomy: Tympanic cavity evacuation and exploration