Head and respiratory system surgery

RESPIRATORY SYSTEM

Various tests are available:

  • Endoscopy is a common test for respiratory failure, however, problems of infection or bleeding in the lungs may require further investigation such as tracheal or bronchoalveolar sampling. These examinations are performed at the clinic.
  • The examination of the pharynx allows us to detect problems such as soft palate, pharyngitis, horniness… when these problems are only expressed during exercise, we have an on-board endoscope that allows us to record the image of the pharynx during the horse’s work, which allows us to refine the diagnosis before a possible surgical intervention

 

UPPER RESPIRATORY TRACT SURGERY

SINUS

The horse’s sinuses are very large and often the site of problems. Sinusitis can be primary or secondary. Tooth infection problems are the primary cause of secondary sinusitis, but maxillary cysts or other more malignant tumors can also cause sinusitis. In order to remove masses (cysts, ethmoidal hematomas, dental tumors) or to extract teeth (premolars, molars), a small “window” can be created in the bones of the head in order to visualize and treat these problems.

PHARYNX

The horse’s palate is made up of a hard and a soft palate. Sometimes the soft palate moves over the epiglottis and since the horse can only breathe through the nose, it can asphyxiate at high speed. Dorsal displacement of the soft palate is a major cause of poor performance in racehorses. The surgical solutions are staphylectomy, thermal palatoplasty (laser) and myectomy. In recent years, a technique of laryngeal advancement (Tie-Forward) has been used with very promising results. This technique consists of an advancement of the larynx, projecting the epiglottis further forward onto the soft palate, preventing it from passing over the epiglottis.

LARYNX

Epiglottis entrapment is easily reduced by standing laser surgery. Subepiglottic cysts are removed with a transoral technique. One of the major respiratory problems of the horse is horniness or laryngeal hemiplegia (mostly left). When working, the horse makes noise (“horny” horse) and cannot breathe properly at high speed (larynx collapse). To correct this real “handicap”, several operations are available. Ventriculocordectomy is the removal of the laryngeal ventricle and vocal cord. This can be done through an incision in the larynx or non-invasively with a laser in endoscopy on a standing horse. Laryngoplasty is the placement of a prosthesis to “open” the larynx by pulling the arytenoid cartilage.

A new technique, the “neuromuscular graft”, is also giving very promising results. In this technique, a nerve is grafted onto the dorsal cricoarytenoid muscle (which is de-innervated during the corning procedure). After a few months, the muscle can contract again and reopen the larynx correctly at high speed.

EPIGLOTTE

The epiglottis can also cause problems (entrapment, subepiglottic cyst, ulcers).

Once again, laser under endoscopy allows to solve these problems in a minimally invasive way and on a standing horse.