Evaluation of peroral transendoscopic contact neodymium:yttrium aluminum garnet laser and snare excision of subepiglottic cysts in horses.

This study developed and tested several techniques to remove cysts located under the epiglottis in horses using a laser or snare tool delivered through the mouth, which reduced recovery time and postoperative care. None of the cysts reoccurred, and symptoms of the cysts, such as breathing difficulty and coughing, were relieved in all but one case.

Overview

• The researchers established three fundamental techniques and one modified version to successfully remove subepiglottic cysts in horses through the mouth, thus avoiding the need for surgical incisions in the larynx or pharynx.
• These techniques were applied to 10 horses of various breeds with an average age of 3.5 years. All horses experienced a complete recovery with only one horse showing minor postoperative symptoms.

Procedure

• The procedures were performed on horses in a lateral position under general anesthesia, which allows for precise manipulation and visualization inside the throat.
• Specifically designed instruments were used, including a guide tube, a cyst snare, and long grasping forceps. Depending on the situation, either a laser or snare—or a combination of both—were used to remove the cysts.
• Bleeding was minimal during all the operations.

First Attempts

• The researchers initially tried to develop a technique for removing the cysts using a laser through the nose, but they were not successful in the first few attempts. The cysts collapsed and disappeared under the soft palate before they could be completely removed.

Postoperative Complications

• After the operations, some horses experienced minor complications. One horse showed significant swelling in the area beneath the epiglottis after the laser procedure which was managed with anti-inflammatory treatment, and another horse developed scar tissue under the epiglottis after the snare procedure which needed to be removed surgically.