Treatment of epiglottic entrapment by transnasal axial division in standing sedated horses using a shielded hook bistoury.

Summary

# Editorial Summary: Transnasal Treatment of Epiglottic Entrapment Epiglottic fold entrapment remains a significant cause of upper airway obstruction in performance horses, yet traditional surgical approaches often require general anaesthesia with associated recovery risks. Lacourt and Marcoux evaluated a novel technique using a shielded hook bistoury passed transnasally to divide the entrapping aryepiglottic fold in eight standing sedated Standardbreds (aged 3–19 years), with follow-up conducted via telephone contact with owners, trainers, and referring veterinarians. The procedure proved successful in all cases, with division achieved within a mean time of 83 seconds and notably, no short- or long-term complications were reported across the cohort. The integral shield mechanism on the bistoury effectively protects adjacent pharyngeal structures from inadvertent laceration during the transection process. For practitioners seeking to manage epiglottic entrapment with reduced anaesthetic risk and rapid resolution, this standing sedation approach merits consideration as a viable alternative to traditional recumbent surgical methods, particularly in high-risk patients or those where prolonged recovery is contraindicated.

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Key Findings

• •Transnasal axial division of entrapping epiglottic fold was successful in all 8 horses using a shielded hook bistoury
• •Mean procedure time was 83 seconds from bistoury advancement to complete transection
• •No short-term or long-term complications were observed in any horse

Conditions Studied