Epiglottic augmentation by use of polytetrafluoroethylene to correct dorsal displacement of the soft palate in a standardbred horse.

This study investigates the use of polytetrafluoroethylene injections to successfully treat dorsal displacement of the soft palate (DDSP), a performance-limiting condition in a 2-year-old Standardbred horse. The DDSP condition, which had remained unaffected by a previous surgical intervention, was significantly improved following the injection and a subsequent rehabilitation regime.

Context and Objective

• The research was conducted on a 2-year-old Standardbred colt suffering from exercise intolerance due to DDSP, a condition where the soft palate in the horse obstructs the airway.
• Initial attempts to correct this condition via a surgical myectomy procedure were unsuccessful, prompting the researchers to explore the use of polytetrafluoroethylene to augment the epiglottis.

Methodology and Approach

• The horse was initially examined using standing endoscopy and lateral laryngeal radiography. These examinations revealed conditions such as a soft and underdeveloped epiglottis and symmetrical movement in the arytenoid cartilages.
• Videoendoscopy was also used during treadmill exercise sessions, revealing repeated dorsal placement of the soft palate. This confirmed the persistent DDSP.
• Following the unsuccessful myectomy surgery and recovery period, the researchers opted to inject polytetrafluoroethylene into the ventral submucosal space of the epiglottis.

Recovery and Results

• Post-injection, the horse underwent an extensive recovery and conditioning period, spanning 21 days of stall rest, five weeks of pasture rest, and two months of treadmill conditioning.
• During this time, further treadmill exercise and endoscopic evaluations were carried out. These showed that the soft palate no longer displayed dorsal displacement during exercise, indicating a successful treatment outcome.

Conclusions

• The researchers concluded that their innovative use of polytetrafluoroethylene was successful in treating DDSP. This treatment could potentially be a practical solution for similar cases where conventional surgeries fail.
• It is suggested that polytetrafluoroethylene increases the rigidity of the epiglottis, enabling it to maintain the proper ventral position of the soft palate.