Laser fenestration of the mesial septum for treatment of guttural pouch chondroids in a pony.

This research team successfully treated a pony suffering from obstruction in the pharyngeal ostium of the left guttural pouch, by removing the chondroids through a laser-generated hole in the mesial septum. Post-treatment, inflammation was noticeably reduced, and the horse was symptom-free and participating in competitions after two months.

Methods and Procedures

• The team implemented a novel approach to the treatment of guttural pouch chondroids – abnormal calcified structures often linked with inflammation and infection.
• They made use of transendoscopic neodymium:yttrium-aluminum-garnet (Nd:YAG) laser to create a fenestration or hole in the mesial septum of the guttural pouch. This was accomplished using direct contact and specific exposure parameters (15-25 W and 4 seconds).
• The tissue that had been dissected was removed via transendoscopic monopolar electrosurgery, employing a loop electrode and a cutting blade.
• Multiple chondroids of different sizes were removed from the left guttural pouch via the fenestration.

Results

• The result was a clear reduction in inflammation of the guttural pouches, attained through the removal of all chondroids and repeated flushing of the left pouch via the right side.
• The pony had to undergo monitored post-procedural care, including transendoscopic lavage or washing every week.
• After two months, when re-evaluated, a permanent septal fenestration was seen, signifying the success of the procedure. The animal was free of any abnormal signs and was actively participating in carriage driving competitions, demonstrating its health.

Conclusions

• This case study highlights the potential of Nd:YAG laser fenestration as a valuable treatment approach for guttural pouch chondroids in horses.
• Especially when there is an associated problem of pharyngeal ostium adhesion due to empyema (pus collection) or chondroids, this method presents an alternative solution in contrast to conventional external surgical approaches.