Ear Surgery Success in Lop-Eared Rabbits: LECA Shows Promise With Careful Management

Evaluation of Lateral Ear Canal Ablation (LECA) as a Surgical Treatment Option for External Ear Canal Disease in Lop-Eared Pet Rabbits (Oryctolagus cuniculus)

Anne Willems, Johannes Hetterich, Milena Thöle, Michael Pees, Michael Fehr, Maximilian Reuschel

Background:
External ear canal disease is a prevalent condition in lop-eared pet rabbits, often complicated by anatomical predispositions leading to chronic inflammation and cerumen accumulation. Traditional medical management frequently fails in severe cases. This study aimed to evaluate the outcomes and complications of lateral ear canal ablation (LECA) as a surgical intervention for rabbits with soft tissue-filled external ear canals, often misclassified as otitis externa on imaging.

Methods:
This retrospective study reviewed medical records from two veterinary clinics between 2015 and 2023. Twenty-five lop-eared pet rabbits diagnosed via computed tomography (CT) with external ear canal soft tissue filling underwent LECA surgery. Data collected included demographics, clinical signs, CT findings, microbiology results, surgical outcomes, complications, and follow-up information. Microbial cultures were performed during surgery. Post-operative follow-up involved owner questionnaires, clinical exams, and, in some cases, repeat CT imaging.

Results:
All rabbits survived surgery. The mean follow-up was 19 days. Post-operative complications were noted in 28% (7/25) of rabbits, mainly wound infections and dehiscence. Complete wound healing occurred in most cases, though one rabbit required prolonged treatment due to a multi-drug-resistant infection. Eighteen rabbits (72%) showed no recurrence of ear disease. Five rabbits were lost to follow-up, and two exhibited disease recurrence at long-term reassessment (543 and 762 days post-surgery). CT scans available for 14 rabbits showed ear condition improvement in 8 cases, stability in 4, and worsening in 2. Culture results showed mixed bacterial infections, including Staphylococcus aureus and Corynebacterium spp. LECA facilitated ear ventilation and cerumen removal, improving the overall quality of life in most cases.

Limitations:
Limitations include the retrospective design, small sample size, short mean follow-up, and variable clinical and microbiological evaluation methods. Histopathological confirmation of "otitis" was not performed, and subjective owner reporting may have biased quality-of-life assessments.

Conclusions:
LECA is a safe and effective surgical option for treating severe external ear canal diseases in lop-eared rabbits when conservative therapy fails. Successful outcomes depend on meticulous surgical technique, rigorous post-operative care, and owner compliance. Further prospective studies with larger cohorts and longer follow-up are needed to optimize treatment strategies and assess long-term outcomes.

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