Ceratohyoidectomy in standing sedated horses.
Authors: Racine Julien, O'Brien Thomas, Bladon Bruce M, Cruz Antonio M, Stoffel Michael H, Haenssgen Kati, Rodgerson Dwayne H, Livesey Michael A, Koch Christoph
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Ceratohyoidectomy for Temporohyoid Osteoarthropathy Temporohyoid osteoarthropathy (THO) causes significant morbidity in horses, presenting with facial nerve paralysis, vestibular dysfunction, and potentially life-threatening complications such as oesophageal impaction, yet general anaesthesia carries inherent risks for affected animals. Racine and colleagues evaluated the feasibility of performing ceratohyoidectomy (CHE) under standing sedation by conducting the procedure on six experimental horses (three euthanased at 30 minutes and three at 7 days post-op) and treating four clinical cases presenting with THO-related complications including facial nerve paralysis, ataxia, and auricular haemorrhage. All procedures were successfully completed with minimal complications; one clinical case experienced intraoperative haemorrhage that was managed effectively with haemostatic forceps, whilst experimental subjects showed no postoperative issues. Vestibular signs and ataxia resolved within days of surgery, though facial nerve paralysis required substantially longer—between 9 days and 6 months—to fully recover; importantly, all clinical cases returned to performance with excellent owner satisfaction over follow-up periods of 9–24 months. Standing CHE represents a viable alternative to general anaesthesia for THO, particularly valuable for horses presenting with severe vestibular deficits where the risks of recumbency anaesthesia are substantial, and should be considered a legitimate treatment option by equine practitioners managing this condition.
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Practical Takeaways
- •Standing CHE is a viable alternative to general anesthesia for treating THO, particularly beneficial for horses with marked vestibular symptoms where GA recovery poses higher risk.
- •Most THO clinical signs resolve quickly post-operatively (within days), though facial nerve paralysis may take several months to fully recover.
- •This technique enables successful return to performance in affected horses with excellent owner satisfaction.
Key Findings
- •Ceratohyoidectomy was successfully performed in all 10 horses (6 experimental + 4 clinical cases) under standing sedation without major complications.
- •Vestibular ataxia and THO symptoms improved within days post-operatively, while facial nerve paralysis recovery took 9 days to 6 months.
- •All 4 clinical cases returned to performance with excellent client satisfaction at 9-24 month follow-up.
- •Standing sedated CHE avoids general anesthesia risks in horses with severe vestibular deficits and ataxia.