Transendoscopic laser surgery to correct nasopharyngeal obstruction caused by head flexion in horses.
Authors: Barton Ann Kristin, Cehak Anja, Rohn Karl, Ohnesorge Bernhard
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Transendoscopic laser surgery for poll-flexion-induced nasopharyngeal obstruction Nine Warmblood horses presenting with exercise-related respiratory noise and poor performance were found on endoscopy to have dynamic nasopharyngeal obstruction during head flexion, with radiographic measurements confirming significantly reduced airway diameter compared to healthy controls. Using transendoscopic laser fenestration to perforate the median septum between the guttural pouches, combined with salpingopharyngeal fold resection on the most severely affected side, the researchers achieved a 64% improvement in mean nasopharyngeal diameter (from 1.67 to 2.58 cm, P = .01), with respiratory noise eliminated or substantially reduced in 7 of 7 horses reassessed 3 days post-operatively. Long-term follow-up at 6 months confirmed sustained performance improvements in 8 horses, suggesting the benefits were not transient. This minimally invasive endoscopic approach offers farriers and performance vets a viable surgical option for athletes experiencing poll-related airway compromise, avoiding the complications associated with conventional open procedures. The technique warrants consideration for any horse exhibiting flexion-dependent respiratory noise that hasn't responded to training or equipment modifications, particularly given the rapid recovery and sustained functional gains observed.
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Practical Takeaways
- •Consider transendoscopic laser surgery for Warmblood horses with poll flexion-induced respiratory obstruction and performance issues; it is minimally invasive with rapid recovery
- •Perform endoscopy during head flexion and lateral radiographs in neutral, extended, and flexed positions to confirm diagnosis before proceeding to surgery
- •Expect improved breathing and performance in most cases within days, with benefits persisting at 6 months post-operatively
Key Findings
- •Transendoscopic laser fenestration of the median septum and salpingopharyngeal fold resection increased nasopharyngeal diameter by 64% (1.67 to 2.58 cm) post-operatively
- •Respiratory noise was reduced or eliminated in 7 of 9 horses (78%) within 3 days of surgery
- •Eight of 9 horses (89%) showed beneficial long-term effects on performance at 6-month follow-up based on owner interview