Outcomes after medical and surgical interventions in horses with temporohyoid osteoarthropathy.
Abstract: Temporohyoid osteoarthropathy (THO) is a cause of neurological disease in horses that is characterised by facial and vestibulocochlear nerve deficits. Studies reporting and comparing survival following medical or surgical treatment of THO are lacking. Objective: To compare survival and prognosis in horses with THO treated medically or surgically, and to report surgical complications. Methods: Retrospective study. Methods: The medical records of horses diagnosed with THO were retrieved, and data on signalment, clinical signs and duration, corneal ulceration and bilateral occurrence were recorded. Neurological severity was graded according to clinical signs. Preoperative radiographic and endoscopic images were graded according to the severity of changes. Factors potentially affecting survival and treatment were compared using Cox proportional hazards regression. Results: A total of 77 horses were identified as having THO during the period 1990-2014. Of these, 25 horses underwent ceratohyoid ostectomy (CHO) and eight underwent partial stylohyoid ostectomy (PSHO). Thirteen of 20, one of 25 and one of eight horses treated by medical therapy, CHO and PSHO, respectively, died or were subjected to euthanasia as a consequence of THO. Compared with CHO, medical therapy was significantly associated with nonsurvival, but there were no significant differences in survival between horses undergoing PSHO and medical therapy. The duration of clinical signs, and neurological, radiographic and endoscopic grades were not associated with survival of THO. However, the age of the horse was significantly associated with poorer survival. Survival time was significantly shorter in the medical therapy group compared with the two surgical groups combined, but did not differ significantly between the two surgical groups. No significant difference between groups was seen in the incidence of surgical complications (33.3% in the PSHO and 22.2% in the CHO group). Conclusions: This was a nonrandomised study of treatment effects on survival and included a low number of cases. Conclusions: The survival prognosis in horses with THO is good to excellent in those submitted to surgical intervention, and fair in those treated with medical therapy alone.
© 2017 EVJ Ltd.
Publication Date: 2017-07-03 PubMed ID: 28517110DOI: 10.1111/evj.12701Google Scholar: Lookup
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- Journal Article
Summary
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The study examines the difference in survival rates and outcomes in horses affected by temporohyoid osteoarthropathy (THO) and treated either medically or surgically. According to the research, surgical intervention results in better survival prognosis compared to merely medical therapy.
Study Methodology
- The researchers performed a retrospective analysis of the medical records of horses diagnosed with THO.
- A variety of details like horse’s age, clinical signs, duration of these signs, occurrence of corneal ulceration and any bilateral occurrence were recorded.
- The severity of the THO was graded based on clinical signs, and severity of pre-operative radiographic and endoscopic images.
- To assess the factors affecting the survival rate and treatment effectiveness, Cox proportional hazards regression was employed.
- A total of 77 horses diagnosed with THO between 1990 and 2014 were treated either medically, or through two types of surgical procedures – ceratohyoid ostectomy (CHO) or partial stylohyoid ostectomy (PSHO).
Key Findings
- Out of the 77 horses, 25 underwent CHO and 8 underwent PSHO. The rest were treated medically.
- It was observed that medical therapy was significantly associated with nonsurvival while surgical treatments – both CHO and PSHO – showed better survival rates. However, there wasn’t a significant difference in survival between horses undergoing PSHO and those treated medically.
- The duration of clinical signs, and grades based on neurological, radiographic and endoscopic images, didn’t show any significant relation with the survival of THO-affected horses.
- The age of the horses, however, was found to be significantly associated with poorer survival rates.
- Though survival time was significantly shorter in horses treated with medical therapy than those treated surgically, the difference in survival time between the two surgical groups wasn’t significant.
- The rate of surgical complications didn’t differ significantly across the two surgical groups, with a 33.3% incidence in the PSHO group and 22.2% in the CHO group.
Conclusions
- Despite the study not being randomized and having a low number of cases, its findings indicate a better survival prognosis for horses diagnosed with THO when submitted to surgical intervention as compared to merely medical therapy.
Cite This Article
APA
Espinosa P, Nieto JE, Estell KE, Kass PH, Aleman M.
(2017).
Outcomes after medical and surgical interventions in horses with temporohyoid osteoarthropathy.
Equine Vet J, 49(6), 770-775.
https://doi.org/10.1111/evj.12701 Publication
Researcher Affiliations
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
- Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California Davis, Davis, California, USA.
MeSH Terms
- Animals
- Anti-Bacterial Agents / therapeutic use
- Anti-Inflammatory Agents / therapeutic use
- Female
- Horse Diseases / therapy
- Horses
- Jaw / pathology
- Joint Diseases / therapy
- Joint Diseases / veterinary
- Male
- Osteoarthritis / drug therapy
- Osteoarthritis / surgery
- Osteoarthritis / veterinary
- Retrospective Studies
Citations
This article has been cited 1 times.- Saito Y, Amaya T. Symptoms and management of temporohyoid osteoarthropathy and its association with crib-biting behavior in 11 Japanese Thoroughbreds.. J Equine Sci 2019;30(4):81-85.
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