Experiences in treatment of epiglottal entrapment using a hook knife per nasum.

The study examines the treatment of a condition called epiglottal entrapment in horses, comparing effectiveness of different procedures. It found that using a curved hook knife inserted through the nasal passage provides an inexpensive, safe, and effective solution for the condition.

Objective and Subject

• The researchers carried out an examination and treatment on 38 horses suffering from epiglottal entrapment— a condition in which the mucous membrane located above the epiglottis wraps around and entraps it, causing respiratory distress.
• The study focused on evaluating the effectiveness of several different treatment methods, the main one being splitting the entrapped mucosa with a curved hook knife through the horse’s nasal passage.

Methodology

• Out of the 38 horses examined, 29 were treated using the hook knife procedure.
• The dorsally displaced mucosa was cut axially using this curved hook knife, a process carried out through (per nasum) the horse’s nose.
• A smaller subset of horses (4) underwent subepiglottal mucosal resection (cutting away the ensnared tissue), and another 4 horses were treated solely with anti-inflammatory throat spray.
• All surgical cases also received anti-inflammatory throat spray and an injected medication called phenylbutazone to manage pain and inflammation.
• Recovery was managed differently; horses treated via a laryngotomy (incision in the larynx) were allowed to rest until the wound healed. Others were gradually reintroduced to exercise, starting with walking and trotting, before being reassessed endoscopically 10 days post-treatment.

Results and Conclusion

• From those treated by the hook knife per nasum, 22 of 29 horses experienced successful alleviation of the entrapment. There were, however, instances of recurrence and cases lost to follow-up.
• From the smaller groups, 2 out of 4 horses treated by mucosal resection and 2 out of 4 treated by a laser technique resulted in a successful outcome, as did 3 out of 4 horses that received only the anti-inflammatory throat spray treatment.
• For some, the disease required more than one operation, and two horses had to undergo a third surgical procedure. 14 horses that received the axial section of the displaced mucosa treatment ran successfully post-surgery without any respiratory problems and four even won races.
• Overall, the study concluded that treating epiglottal entrapment in horses using a hook knife inserted via the nasal passages was relatively affordable, safe and successful.