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

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.