Transoral axial division, under endoscopic guidance, for correction of epiglottic entrapment in horses.

The research investigates the use of a surgical method called transoral axial division, assisted by endoscopic guidance, to correct a condition in horses known as epiglottic entrapment. This study was conducted on 20 horses confirming the method to be safe, economically feasible, and an effective alternative compared to other methods for treating the specified ailment.

Study Background and Objectives

• The study primarily aimed to assess the efficacy of a surgical procedure known as transoral axial division as a treatment for epiglottic entrapment in horses. This condition involves the abnormal covering of the epiglottis, a flap of cartilage located at the base of the tongue that keeps food from going into the windpipe, by the aryepiglottic folds.
• While several treatments are available for this condition, the researchers sought to determine whether transoral axial division represented a useful, safe, and cost-effective alternative.

Methodology

• The study involved 20 horses diagnosed with epiglottic entrapment. The horses’ average age was 3 years old, with the majority of the subjects being Standardbreds (18 out of 20) and the rest (2 out of 20) were Thoroughbreds.
• Prior to the surgery, an endoscopic examination was performed to confirm the diagnosis. The entrapment was categorized based on the thickness and ulceration of the tissue causing the entrapment.
• Following the transoral axial division surgery, the horses received anti-inflammatory medication and underwent a period of controlled physical activity for one week before returning to their regular training.

Key Findings

• All horses resumed their prior level of racing or training following the surgery.
• Epiglottic entrapment recurred in 10% of the horses (2 out of 20), and 2 horses developed dorsal displacement of the palate post-surgery.
• Most importantly, no correlation was found between epiglottic entrapment and dorsal displacement of the palate with epiglottic hypoplasia (underdeveloped epiglottis).

Implications and Recommendations

• The study establishes transoral axial division, under endoscopic guidance, as a promising therapeutic alternative for the management of epiglottic entrapment in horses.
• However, the researchers suggest that horses with severe entrapment characterized by thick tissue and heavy ulceration may still be best managed by surgical resection, which involves removing the entrapping tissue.