Endoscope-assisted three-wire technique for extensive nasal septum resection in horses.
Authors: Ratliff Bridget L, Bauck Anje G, Roe Heather A, Freeman David E
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Dorsal displacement of the epiglottis and other obstructive conditions affecting the nasal septum can severely compromise performance, yet extensive surgical resection has traditionally presented challenges around visualisation and haemorrhage control. Ratliff and colleagues describe a modified three-wire technique using endoscopic guidance to resect the nasal septum in 13 horses, where obstetrical wires are placed under direct visualisation for ventral and caudal incisions, with a dorsal wire placed via a trephine opening, followed by rostral scalpel incision and sequential wire-cutting. All horses showed improved exercise tolerance and eliminated or substantially reduced abnormal respiratory noise post-operatively, with all owners satisfied with outcomes, though intraoperative complications including wire entanglement (requiring conversion to intraoral placement in two cases) and haemorrhage-related visualisation loss were noted. The endoscopic approach eliminates the need for a large tracheotomy for anaesthetic delivery in smaller horses, making the procedure more practical for practice settings, whilst the authors highlight that future assessment of dynamic airway obstruction at speed—rather than static examination at walk—may better predict return to athletic function. For practitioners managing horses with extensive septal pathology, this refined technique offers a safer, more controlled approach to what remains a technically demanding procedure, though recognition of potential complications and appropriate case selection remain essential.
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Practical Takeaways
- •This endoscopic three-wire technique allows extensive nasal septum resection without a large tracheotomy in smaller horses, reducing anesthetic complications while achieving consistent respiratory noise improvement
- •Anticipate potential intraoperative hemorrhage and wire entanglement as complications; have contingency plans for conversion to intraoral wire placement available
- •Postoperative assessment of respiratory noise at speed (not just walk/trot) is more relevant for determining true return to athletic function in sport horses
Key Findings
- •Endoscope-assisted three-wire technique successfully performed extensive nasal septum resection in 13 horses with improved exercise tolerance and eliminated abnormal respiratory noise in all cases
- •Technical complications occurred in 2 of 13 horses (15%), requiring conversion to intraoral wire placement due to wire entanglement or hemorrhage obscuring endoscopic view
- •All horse owners were satisfied with outcomes; one Thoroughbred racehorse returned to modest racing performance postoperatively