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Evaluation of epiglottic augmentation by use of polytetrafluoroethylene paste in horses.

Abstract: Epiglottic augmentation was evaluated in 7 horses, using 7 ml of polytetrafluoroethylene (polytef) paste injected submucosally on the ventral surface of the epiglottis. In 6 horses, an Arnold-Bruning intracordal injection syringe, specifically designed to inject polytef into paralyzed vocal folds in human beings, was used. At necropsy 60 days after surgery, group mean thickness measurement 20 mm from the epiglottic tip was 40% greater (P less than 0.01) and, at the epiglottic attachment of the aryepiglottic fold, was 29% greater (P less than 0.01) in the 6 polytef-augmented horses than in clinically normal nonsurgically treated controls. At necropsy, extensive epiglottic thickening was seen. This thickening was exclusively attributable to distention of submucosal areas in the ventral aspect of the epiglottis, with foreign body granulomata surrounded by fibrous connective tissue. In 1 horse, polytef paste was injected by use of a disposable syringe and needle. Excess ventral epiglottic swelling and exposed epiglottic cartilage was seen during subsequent endoscopy. At necropsy 60 days after surgery, the epiglottic contour remained deformed and a large deep mucosal ulcer was observed at the injection site. Histologic examination revealed necrotizing suppurative inflammation that extended into the epiglottic cartilage. Surgery was not technically difficult to perform through a laryngotomy, and all horses tolerated the procedure without apparent discomfort. Endoscopy performed after surgery revealed unremarkable and uniform response to the polytef paste in 4 horses, and in 3 horses, revealed excess swelling and inflammation of the ventral epiglottic tissue that resolved over time.(ABSTRACT TRUNCATED AT 250 WORDS)
Publication Date: 1991-11-01 PubMed ID: 1785738
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  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

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This research evaluates the use of polytetrafluoroethylene paste as an augmentation to the epiglottis of horses. The study discovered that this treatment resulted in a substantial increase in the thickness of the epiglottis, with some cases also showing swelling and inflammation which, however, resolved over time.

Method

  • The research involved seven horses that underwent epiglottic augmentation using polytetrafluoroethylene (polytef) paste.
  • The paste was injected submucosally on the ventral surface of the epiglottis, which refers to the underside surface, using a specifically designed Arnold-Bruning intracordal injection syringe.

Findings

  • In relation to thickness, the study accounted a 40% augmentation in the mean thickness measured 20 mm from the epiglottic tip and a 29% increment in the area where the aryepiglottic fold meets with the epiglottis.
  • These measurements were compared to clinically normal and non-surgically treated controls.
  • The unusual epiglottic enlargement observed at autopsy mainly resultes from distention of the submucosal areas located on the ventral aspect of the epiglottis. This thickening was characterized by foreign body granulomata (a granulated tissue formed around a foreign substance in the body) encapsulated by fibrous connective tissue.
  • In one instance, the polytef paste was injected through a disposable syringe and needle. The resultant condition included excess swelling on the ventral epiglottic and uncovered epiglottic cartilage, which was visible during subsequent endoscopy. This horse also showed a deformed epiglottic contour and a large deep mucosal ulcer at the injection site 60 days post-surgery which were found to be due to necrotizing suppurative inflammation (an inflammation type that causes the death of surrounding tissue) that extended into the epiglottic cartilage.

Additional Observation and Conclusion

  • Endoscopy revealed that four horses had a uniform and unremarkable response to the polytef paste.
  • Three horses displayed notable swelling and inflammation of the ventral epiglottic tissue. However, these conditions were found to have resolved over time.
  • The surgical procedure was stated as uncomplicated when performed through a laryngotomy and caused no evident discomfort to the horses.

Cite This Article

APA
Tulleners E, Hamir A. (1991). Evaluation of epiglottic augmentation by use of polytetrafluoroethylene paste in horses. Am J Vet Res, 52(11), 1908-1916.

Publication

ISSN: 0002-9645
NlmUniqueID: 0375011
Country: United States
Language: English
Volume: 52
Issue: 11
Pages: 1908-1916

Researcher Affiliations

Tulleners, E
  • Department of Clinical Studies, University of Pennsylvania, School of Veterinary Medicine, Kennett Square 19348.
Hamir, A

    MeSH Terms

    • Animals
    • Epiglottis / diagnostic imaging
    • Epiglottis / pathology
    • Epiglottis / surgery
    • Evaluation Studies as Topic
    • Horses / surgery
    • Laryngoscopy / veterinary
    • Larynx / surgery
    • Male
    • Ointments
    • Polytetrafluoroethylene
    • Postoperative Care / veterinary
    • Radiography

    Citations

    This article has been cited 1 times.
    1. Fretheim-Kelly ZL, Halvorsen T, Clemm H, Roksund O, Heimdal JH, Vollsæter M, Fintl C, Strand E. Exercise Induced Laryngeal Obstruction in Humans and Equines. A Comparative Review. Front Physiol 2019;10:1333.
      doi: 10.3389/fphys.2019.01333pubmed: 31736771google scholar: lookup