Ceratohyoidectomy in standing sedated horses

Abstract

Objective To investigate the feasibility and complications associated with ceratohyoidectomy (CHE) in standing sedated horses unaffected (experimental horses) and standing sedated horses affected (clinical cases) with temporohyoid osteoarthropathy (THO). Study design Case series. Animals Six experimental horses and four clinical cases. Methods Standing CHE was performed in six experimental horses euthanized 30 minutes (n = 3) and 7 days (n = 3) postoperatively. The four clinical cases were presented because of central facial nerve paralysis (n = 3), vestibular ataxia (n = 3), auricular hemorrhage (n = 2), quidding (n = 1), and oesophageal impaction (n = 1). Evolution was assessed by clinical examination during hospitalization and later by telephone interviews for the clinical cases. Results The procedure was successfully performed in all horses. Experimental horses did not show any short‐term postoperative complications. Hemorrhage was experienced intraoperatively in one of the clinical cases and was successfully managed with placement of hemostatic forceps. Vestibular ataxia and other symptoms of THO improved within days, but facial nerve paralysis did not improve until 9 days to 6 months after surgery. Follow‐up ranged from 9 to 24 months. All clinical cases returned to performance, and client satisfaction was excellent. Conclusion Ceratohyoidectomy was consistently feasible in standing sedated horses. The method did not result in postoperative complications and led to resolution of clinical signs associated with THO. Clinical significance Standing CHE should be considered in horses affected with THO, especially when horses present with marked vestibular deficits and ataxia, to reduce risks associated with recovery from general anesthesia.

Outcome of a Ceratohyiodectomy in a Criollo Mare with Temporohyoid Osteoarthropathy

“…Although profuse hemorrhage in the surgical field occurred, the vessel was clamped and ligated. This was the main intraoperative complication in our patient which was also reported to occur in other cases [13,16]. Other possible complications for CHO include damage of neural structures and some horses can experience respiratory distress shortly after anesthesia recovery requiring temporary tracheostomy [5,16].…”

“…Partial stylohyoidectomy was also described as a surgical option for THO [1], however, it is known to cause more complications and to have a higher recurrence rate of clinical signs due to regrowth of the stylohyoid bone [15]. The ceratohyoidectomy aims to reduce the forces on the THJ subsequently reducing the pain and clinical signs associated with bone fracture and proliferation [16,21].…”

“…Other possible complications for CHO include damage of neural structures and some horses can experience respiratory distress shortly after anesthesia recovery requiring temporary tracheostomy [5,16]. Racine et al [16] described the CHO performed in standing horses, which can reduce anesthetic complications but not the complications of the procedure.…”

“…There are several reports of ceratohyoidectomy for treatment of THO in different countries [2,5,[13][14][15][16]19,21], however, to the author's knowledge, this is the first report of this procedure in Brazil. Therefore, the aim of this study is to report a case and outcome of a ceratohyoidectomy procedure in a Criollo mare presenting THO of the right THJ.…”

Standing osteosynthesis of an accessory carpal bone fracture in a Warmblood mare with a 6‐hole 3.5 talonavicular fusion plate and 3.5‐mm screws

“…Over the last decade, there has been a substantial increase in the number and type of surgical procedures performed under standing sedation in the horse, that would previously have been performed under general anaesthesia (Elce & Richardson, 2002;Gasiorowski & Richardson, 2014;Payne & Compston, 2012;Racine et al, 2019). Particularly for fracture patients, recovery from general anaesthesia represents a significantly increased risk for the fixation as well as the patient's outcome (Johnston et al, 1995(Johnston et al, , 2002Mee et al, 1998).…”