Outcomes after medical and surgical interventions in horses with temporohyoid osteoarthropathy.
Authors: Espinosa P, Nieto J E, Estell K E, Kass P H, Aleman M
Journal: Equine veterinary journal
Summary
Temporohyoid osteoarthropathy (THO) causes progressive cranial nerve dysfunction in horses, yet limited evidence exists comparing outcomes between medical and surgical management approaches. This retrospective analysis of 77 cases diagnosed between 1990 and 2014 evaluated survival rates following three treatment pathways: medical therapy alone (20 horses), ceratohyoid ostectomy or CHO (25 horses), and partial stylohyoid ostectomy or PSHO (8 horses), with statistical modelling to identify prognostic factors. Surgical intervention substantially improved survival, with only 4% mortality in the CHO group and 12.5% in the PSHO group compared to 65% in medically managed horses; notably, advancing age was the only clinical or imaging variable significantly associated with poorer outcomes, whilst neurological severity, radiographic changes, and disease duration did not predict survival. Surgical complication rates were comparable between techniques (22–33%), indicating both approaches are technically viable; these findings suggest that farriers and veterinarians should counsel owners towards early surgical referral for THO cases, particularly in younger horses where prognosis is considerably more favourable than with conservative management alone.
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Practical Takeaways
- •Surgical intervention for THO offers good to excellent survival prognosis compared to fair outcomes with medical therapy alone; recommend referring suitable surgical candidates early
- •Age is a significant prognostic factor with older horses having poorer outcomes; discuss realistic expectations with owners of geriatric patients
- •Both surgical approaches have acceptable complication rates; choice between techniques may be individualized without significant difference in outcome
Key Findings
- •Surgical intervention (ceratohyoid ostectomy or partial stylohyoid ostectomy) was significantly associated with improved survival compared to medical therapy alone
- •Only 1 of 25 horses undergoing ceratohyoid ostectomy and 1 of 8 undergoing partial stylohyoid ostectomy died or were euthanised due to THO, compared to 13 of 20 treated medically
- •Older age was significantly associated with poorer survival regardless of treatment modality
- •Surgical complication rates were low and similar between surgical groups (22.2% for ceratohyoid ostectomy, 33.3% for partial stylohyoid ostectomy)