Transendoskopische Therapie eines intermittierenden Epiglottic Entrapment am stehenden Pferd

Abstract

Epiglottic entrapment can be associated with poor performance in- and exspiratory stertor and occasionally with coughing (Honnas and Wheat 1988; Robertson, 1991; Lumsden et al., 1994; Lumsden at al. 1995). But it can also be an incidental finding (Ferraro, 1990). A 14 year old Trakehner stallion was presented to the Veterinary Hospital of the University of Zurich with a history of an abnormal inspiratory noise increasing with exercise. The general physical examination showed no abnormalities. By endoscopy during exercise on a high-speed treadmill the diagnosis of intermittent epiglottic entrapment could be made. Therapy consisted of two transendoscopic surgeries two days apart. In the first session subepiglotteal tissue was resected via a transoral approach, in a second session the aryepiglottic folds were partly removed. Both manipulations were performed electrosurgically with a wire snare in the standing, sedated horse and local anaesthesia of the mucosal membranes. No medication was given after surgery. The horse was fed fresh gras and was walked daily for 15 minutes for one week. Six days after the second surgery no abnormalities on general physical examination and during an endoscopy at rest were present. By exercise endoscopy on the treadmill the Epiglottic entrapment could not be induced any more neither at the same or at higher exercise intensities than before surgery. The main advantages of the surgical technique used in this case are the easy to perform procedure, minimal trauma by the transoral approach and a short reconvalescence period.