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Transendoscopic Laser Surgery to Correct Nasopharyngeal Obstruction Caused by Head Flexion in Horses

Barton, Ann Kristin, Cehak, Anja, Rohn, Karl, Ohnesorge, Bernhard
Veterinary surgery 2014 v.43 no.4 pp. 418-424
endoscopy, exercise test, experimental design, guttural pouch, head, horses, laser surgery, nasopharynx, pouches, radiography, radiology, resection
OBJECTIVE: To determine outcome after transendoscopic laser fenestration of the median septum and removal of the salpingopharyngeal fold of the guttural pouch on nasopharyngeal obstruction caused by poll flexion in Warmblood horses. STUDY DESIGN: Clinical study. ANIMALS: Horses (n = 9). METHODS: Nine horses with a history of performance insufficiency and respiratory noise during poll flexion were examined. On endoscopy, an often asymmetric dorsoventral obstruction of the nasopharynx occurred during poll flexion. Left lateral radiographs were taken in neutral, extended, and flexed head positions showed that mean nasopharyngeal diameter during poll flexion was significantly smaller than in healthy horses. Transendoscopic laser fenestration of the median septum between the guttural pouches was fenestrated and on the worst affected side, resection of the salpingopharyngeal fold was performed for correction. Three days after surgery a follow‐up examination including an exercise test, endoscopy, and radiology was performed in 7 horses. RESULTS: Mean ± SD nasopharyngeal diameter based on radiographic measurements had increased significantly by 64% from 1.67 ± 0.49 to 2.58 ± 0.61 cm (P = .01) and the respiratory noise was reduced or eliminated in 7 horses. Six months after surgery, a beneficial long‐term effect on performance was confirmed by an owner interview in 8 horses. CONCLUSIONS: Transendoscopic laser surgery offers a promising low‐risk treatment option for horses suffering from nasopharyngeal obstruction caused by poll flexion.