Treatment of temporohyoid osteoarthropathy in horses with a basihyoid-ceratohyoid disarticulation technique: 6 cases (2018–2019)

Abstract

OBJECTIVE To describe a technique for basihyoid-ceratohyoid disarticulation (BCD) in standing sedated horses affected by temporohyoid osteoarthropathy (THO) and report outcomes for horses that underwent the procedure. ANIMALS 6 client-owned horses. PROCEDURES Electronic medical records of a veterinary teaching hospital were searched to identify horses that underwent BCD for treatment of THO from 2018 to 2019. Signalment, clinical data, use of the horse, and complications were recorded. Follow-up data obtained by telephone interview with owners included the clinical outcome and time to improvement after surgery, any persistent clinical signs, horse's activity level before onset of clinical signs and after BCD, subsequent use of the horse, and whether they would pursue the same treatment again. RESULTS All horses tolerated the procedure well, with no complications and improved neurologic function after BCD. Five of 6 horses had a reported activity level equal to or greater than that prior to having signs of THO. Three of 3 horses with acute ataxia prior to BCD reportedly had full resolution of this sign; 3 of 4 horses with facial nerve deficits prior to BCD had mild residual facial nerve deficits at follow-up. All owners indicated they would pursue BCD again. CONCLUSIONS AND CLINICAL RELEVANCE The BCD procedure was performed safely in this sample of THO-affected horses that were sedated while standing, avoiding risks associated with general anesthesia and resulting in no adverse effects such as iatrogenic injury to neurovascular structures. (J Am Vet Med Assoc 2021;259:300–305)

Standing surgery among equine board certified surgeons: Survey regarding current use and trends

“…As mentioned for standing arthroscopy and limb fracture repair, this trend seems to follow the positive results in recently published studies, 8,16 particularly if we consider the high risk of peri‐anaesthetic complications in Draught breeds undergoing laryngoplasty and laryngeal reinnervation 24,34 . Similarly, results from recent literature may have also affected the trend seen for other listed procedures (i.e., transarterial coil embolisation and ceratohyoidectomy), where surgeons mainly switched to perform them standing in the last 5 years despite still not being commonly performed standing by most 7,17–20 …”

“…Unfortunately, the relation between training modalities and year of board certification did not reach statistical significance ( p = 0.09). Lastly, current literature may support the presumption that pioneers of standing procedures are usually self‐trained surgeons that are familiar with a procedure under GA prior to making the switch 1–21 …”

“…24,34 Similarly, results from recent literature may have also affected the trend seen for other listed procedures (i.e., transarterial coil embolisation and ceratohyoidectomy), where surgeons mainly switched to perform them standing in the last 5 years despite still not being commonly performed standing by most. 7,[17][18][19][20] Five of the 36 listed procedures were not performed standing or under GA by most respondents. For some procedures, this could be attributed to a lack of caseload (i.e., nasal septum resection or laparoscopic nephrectomy), while the need of advanced surgical skills and/or training may be responsible for others (i.e., laryngeal reinnervation, laparoscopic diaphragmatic hernia repair and epiploic foramen closure).…”

“…Numerous studies have been published over the last 10–20 years describing equine standing surgical procedures that were previously performed under general anaesthesia (GA), which may suggest that standing surgery is becoming more prevalent among equine surgeons 1–21 . Avoiding the risks associated with GA, with a reported mortality and morbidity rate up to 1.4% and 17.5%, respectively, and decreasing the cost associated with GA are the most frequently reported reasons to perform standing surgery 1,7,22–24 .…”