32


EQUINE VETERINARY EDUCATION / AE / JANUARY 2020


intervention was wise since the persistent displacement was most likely a result of continued palatal inflammation that resolved with further time. The caudal approach to the palate edge can be


achieved via laryngotomy or tracheotomy. Given the horse’s age, the tracheotomy approach made good sense and allowed the procedure to be performed standing. If this condition were evident in a neonate, keeping the foal still enough to complete the procedure without complications would have been a challenge. An alternative approach to consider would be i.v. anaesthesia, dorsal recumbency and approaching the caudal palate transendoscopically through a laryngotomy (Fig 3) (Parente 2011). Application of laser energy to a cystic structure has been


reported in animals (Blikslager et al. 1993; Gemensky-Metzler et al. 2004) and has two significant advantages. The first is the minimally invasive approach to get a fibre to the surgical site which limits the complications associated with a more open approach surgery. Second, more importantly, it enables targeted destruction of the cystic tissue with minimal impact on adjacent tissue. While some cystic structures can be isolated and resected from the underlying normal tissue, these palatal cysts cannot, and thus resection of the cystic structures with standard surgical instruments in this horse would have resulted in irreparable damage to the palate. The amount of laser energy to employ is not well established. Considering effective cyst destruction essentially requires the intracellular fluid of the cells lining the cyst to boil, the amount of energy required is likely less than we would estimate, and distribution of the energy may be enhanced if some application can be achieved prior to cyst rupture. The amount of energy used by the authors is valuable information. As reported, 250 joules/cyst was enough to effectively destroy the cysts. We could speculate that less energy may have been just as effective and resulted in less post-operative soft palate inflammation with a quicker correction of palate position. While impossible to accurately measure under these conditions laser fluence, which includes the surface area over which the energy is applied, is another component of the procedure that should be considered when critically evaluating the efficacy of a laser procedure.


Author’s declaration of interests No conflicts of interest have been declared.


Ethical animal research Not applicable.


Source of funding None.


References


Aitken, M.R. and Parente, E.J. (2011) Epiglottic abnormalities in mature nonracehorses: 23 cases (1990-2009). J. Am. Vet. Med. Assoc. 238, 1634-1638.


Blikslager, A., Tate, L.P. Jr and Weinstock, D. (1993) Effects of neodymium: yttrium aluminum garnet laser irradiation on endometrium and on endometrial cysts in six mares. Vet. Surg. 22, 351-356.


Dobesova, O., Schwarz, B., Velde, K., Jahn, P., Zert, Z. and Bezdekova, B. (2012) Guttural pouch mycosis in horses: a retrospective study of 28 cases. Vet. Rec. 171, 561.


Gemensky-Metzler, A.J., Wilkie, D.A. and Cook, C.S. (2004) The use of semiconductor diode laser for deflation and coagulation of anterior uveal cysts in dogs, cats and horses: a report of 20 cases. Vet. Ophthalmol. 7, 360-368.


Holcombe, S.J., Hurcombe, S.D., Barr, B.S. and Schott, H.C. (2012) Dysphagia associated with presumed pharyngeal dysfunction in 16 neonatal foals. Equine Vet. J. 44, Suppl. 41, 105-108.


Lindegaard, C., Husted, L., Ullum, H. and Fjeldborg, J. (2007) Sedation with detomidine and acepromazine influences the endoscopic evaluation of laryngeal function in horses. Equine Vet. J. 39, 553-556.


Parente, E.J. (2011) Congenital abnormalities of the respiratory system. In: Equine Reproduction. Eds: A.O. McKinnon, E.L. Swires, W.E. Vaala and D.D. Varner. Wiley, Hoboken. pp 609-614.


Sinovich, M., Kelly, P.G. and Archer, D.C. (2020) A novel approach for palatal cyst ablation in a horse. Equine Vet. Educ. 32, 25-29.


Virgin, J.E., Holcombe, S.J., Caron, J.P., Cheetham, J., Kurtz, K.A., Roessner, H.A., Ducharme, N.G., Hauptman, J.G. and Nelson, N.C. (2016) Laryngeal advancement surgery improves swallowing function in a reversible equine dysphagia model. Equine Vet. J. 48, 362-367.


Continued from page 28


masses in horses: 32 cases (1993-2000). J. Am. Vet. Med. Assoc. 220, 1192-1197.


Orsini, J.A. (2002) Chronicle of laser usage in equine surgery. Clin. Tech. Equine Prac. 1, 3-8.


Palmer, S.E. (2003) The use of lasers for treatment of upper respiratory tract disorders. Vet. Clin. Equine 19, 245-263.


Parente, E.J. (2002) Tranendoscopic axial division of epiglottic entrapment. Clin. Tech. Equine Prac. 1, 9-12.


Parente, E.J. (2011) Congenital abnormalities of the respiratory system. In: Equine Reproduction, Eds: A.O. McKinnon, E.L. Swires, W.E. Vaala and D.D. Varner. Wiley, Hoboken. pp 609-614.


Robertson, J.T. (2007) Surgical treatment of developmental cysts of the pharynx, larynx and the cervical region of the horse. Equine Vet. Educ. 19, 137-138.


Salz, R.O., Ahern, B.J. and Lumsden, J.M. (2013) Subepiglottic cysts in 15 horses. Equine Vet. Educ. 25, 403-407.


Sullins, K.E. (2002) Minimally invasive laser treatment of arytenoid chondritis in horses. Clin. Tech. Equine Prac. 1, 13-16.


Sullins, K.E. (2012) Lasers in veterinary surgery. In: Equine Surgery, 4th edn., Eds: J.A. Auer and J.A. Stick, W.B. Saunders, St Louis. pp 165- 181.


Sullivan, E.K. and Parente, E.J. (2003) Disorders of the pharynx. Vet. Clin. North Am. Equine Pract. 19, 159-167.


Tulleners, E.P. (1991) Evaluation of peroral transendoscopic contact neodymium:yttrium aluminium garnet laser and snare excision of subepiglottic cysts in horses. J. Am. Vet. Med. Assoc. 198, 1631- 1635.


© 2018 EVJ Ltd


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76