Retrospective study of neurological signs and management of seven English horses with temporohyoid osteoarthropathy

Abstract

Summary This retrospective study summarises the case details, presenting signs, management and outcome in cases of temporohyoid osteoarthropathy (THO) and describes the findings of diagnostic imaging modalities. The condition appears to be relatively rare in Europe and the objective of this study is to make clinicians aware that THO can have a range of various neurological and clinical presentations. The records of 2 referral equine practices in England were reviewed and 7 horses with THO diagnosed on guttural pouch endoscopy indentified. The clinical and neurological signs, diagnostic procedures, treatment and outcomes were reviewed. Although small, this group is the largest case series of THO from Europe. One horse was a yearling, whereas THO is generally considered usually to affect middle aged and older horses. Computed tomography was used to confirm the diagnosis and demonstrated stylohyoid bone fractures in 2 cases while there was mild increased radionuclide uptake in one of 2 cases undergoing nuclear scintigraphy. Treatment is still controversial, although ceratohyoidectomy led to complete resolution of signs in 2 of 5 cases thus treated and improvement in the other 3. One horse with mild signs treated with antimicrobials and nonsteroidal anti‐inflammatory drugs made a full recovery while another, presented with head shaking and managed with a phased exercise programme, improved but did not resolve completely.

Temporohyoid osteoarthropathy in the horse

“…; Palus et al . ). It is generally described as a disease of middle‐aged horses, although more recent reports attribute a variety of clinical syndromes in young horses to THO (Hassel et al .…”

“…1995; Newton and Knottenbelt 1999; Palus et al . ). More subtle events associated with the use of a mouth gag and forceful tongue manipulations during dental procedures and oral examinations, or nasogastric intubations have triggered acute clinical manifestations of THO (Walker et al .…”

“…; Palus et al . ). In this context, it is plausible that THO could be a potential long‐term complication of the laryngeal tie‐forward procedure, but reports of this complication are unknown to the authors.…”

“…; Palus et al . ). Patients with non‐neurological THO are most likely to present less advanced stages of this progressive, degenerative disease.…”

Temporohyoid osteoarthropathy with otitis media et interna attended by vestibular disease in the horse: Case report

“…In einer retrospektiven Studie zeigten zwei von fünf Pferden eine vollständige Genesung nach Keratohyoidektomie und weitere zwei eine Besserung der Symptome (Palus et al 2011).…”