Surgical treatment for epiglottic entrapment in horses: 51 cases (1981-1992)
Lumsden, J.M.; Stick, J.A.; Caron, J.P.; Nickels, F.A.
Journal of the American Veterinary Medical Association 205(5): 729-735
1994
ISSN/ISBN: 0003-1488 PMID: 7989244 Document Number: 438297
Medical records of 51 horses with epiglottic entrapment were reviewed, and the outcome after surgical treatment was evaluated by use of results from a survey of owners and from race records. Horses with epiglottic entrapment and no additional problem (uncomplicated) of the nares, nasal passages, pharynx, or larynx (upper airway) that were treated by transoral axial division (group 1) or resection via laryngotomy (group 2), and horses with epiglottic entrapment complicated by an additional upper airway abnormality (group 3) were compared. The cost of treatment, duration of hospitalization, time to first race start after surgery, and complication rate were significantly less in horses in group 1, compared with those in horses of group 2. Owner survey indicated that a significantly greater percentage (82%) of horses in group 1 had a successful outcome after transoral axial division, compared with that (27%) of horses, in group 2. Analysis of race records indicated that performance was similar between horses in groups 1 and 2, and significantly more horses with an additional upper airway lesion (group 3) failed to return to racing than did horses with uncomplicated epiglottic entrapment (groups 1 and 2). Transoral axial division of the aryepiglottic fold is recommended as an appropriate treatment for uncomplicated epiglottic entrapment. The authors state that resection via laryngotomy should be reserved for treatment of epiglottic entrapment associated with excessively thick and scarred aryepiglottic folds and for intermittent epiglottic entrapment in horses for which surgical correction is deemed appropriate. Horses with epiglottic entrapment complicated by previous aryepiglottic fold surgery or another upper airway abnormality, particularly epiglottic deformity or dorsal displacement of the soft palate, should receive a less favourable prognosis for return to athletic performance.