Nd:YAGlaser‐assisted transendoscopic procedure for treatment of otitis media in a horse

Abstract

Summary An 8‐year‐old Warmblood gelding was referred for evaluation of headshaking to the Clinic for Horses, University of Veterinary Medicine Hannover. Based on clinical signs and computed tomography – as well as magnetic resonance imaging – findings, otitis media was diagnosed. Medical treatment including trimethoprim potentiated sulfadimethoxine and meloxicam for 3 weeks did not result in cessation of clinical signs. Therefore, the tympanic cavity was opened transendoscopically using an Nd:YAG‐laser via the guttural pouch according to surgical procedures in human and small animal medicine, leading to a considerable improvement of clinical signs.

Standing surgical procedure for treatment of otitis media in a horse

“…This long‐term treatment is often difficult for owners to maintain and may seem costly to the client, reducing owner compliance. The first surgical treatment of otitis media was reported by Uhlendorf et al (2017), who described the enlargement of a perforation into the tympanic bulla with the use of Nd:YAG LASER on a horse under general anaesthesia. The enlargement of the perforation improved drainage of the tympanic bulla into the guttural pouch.…”

“…The recommended medical treatment for otitis media is long term (Slovis, 2012) and sometimes unsuccessful (Uhlendorf et al, 2017). This long-term treatment is often difficult for owners to maintain and may seem costly to the client, reducing owner compliance.…”

“…However, the success rate of medical management of otitis media in horses is difficult to ascertain due to the lack of evidence‐based research. The first surgical treatment of otitis media in a horse was described by Uhlendorf et al (2017), after 3 weeks of unsuccessful medical management. They described a transendoscopic technique to enlarge a perforation in a septic tympanic bulla cavity with a neodymium‐doped yttrium aluminium garnet (Nd:YAG) LASER, to improve drainage of the tympanic cavity.…”

“…They described a transendoscopic technique to enlarge a perforation in a septic tympanic bulla cavity with a neodymium‐doped yttrium aluminium garnet (Nd:YAG) LASER, to improve drainage of the tympanic cavity. The tympanic cavity was accessed via the guttural pouch and the procedure was performed under general anaesthesia (Uhlendorf et al, 2017).…”

“…Horses with more advanced stages of otitis media, may present with head tilt, nystagmus, ataxia, muzzle deviation, decreased lacrimation, ear paresis, corneal ulceration, and lethargy (Blyth, 1997;Watrous, 1987).Treatment of otitis media usually relies on long-term medical management, using a combination of trimethoprim-sulphadiazine and non-steroidal anti-inflammatories (NSAIDs) (Slovis, 2012).However, the success rate of medical management of otitis media in horses is difficult to ascertain due to the lack of evidence-based research. The first surgical treatment of otitis media in a horse was described by Uhlendorf et al (2017), after 3 weeks of unsuccessful medical management. They described a transendoscopic technique to enlarge a perforation in a septic tympanic bulla cavity with a neodymium-doped yttrium aluminium garnet (Nd:YAG) LASER, to improve drainage of the tympanic cavity.…”