Racine Julien, O'Brien Thomas, Bladon Bruce M, Cruz Antonio M, Stoffel Michael H, Haenssgen Kati, Rodgerson Dwayne H, Livesey Michael A, Koch Christoph
Department of Equine Surgery, Swiss Institute for Equine Medicine, University of Bern, Bern, Switzerland.
Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Vet Surg. 2019 Nov;48(8):1391-1398. doi: 10.1111/vsu.13319. Epub 2019 Aug 30.
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).
Case series.
Six experimental horses and four clinical cases.
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.
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.
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.
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.
探讨在站立镇静状态下，未受颞下颌关节骨关节炎（THO）影响的马（实验马）和受THO影响的站立镇静马（临床病例）中进行甲状舌骨切除术（CHE）的可行性及相关并发症。
病例系列研究。
6匹实验马和4例临床病例。
对6匹实验马在术后30分钟（n = 3）和7天（n = 3）实施安乐死并进行站立CHE。4例临床病例因中枢性面神经麻痹（n = 3）、前庭性共济失调（n = 3）、耳部出血（n = 2）、吐草（n = 1）和食管阻塞（n = 1）而就诊。住院期间通过临床检查评估病情进展，后期对临床病例通过电话访谈进行评估。
所有马匹手术均成功完成。实验马术后短期内未出现任何并发症。1例临床病例术中出现出血，通过放置止血钳成功处理。THO的前庭性共济失调和其他症状在数天内有所改善，但面神经麻痹直到术后9天至6个月才有所改善。随访时间为9至24个月。所有临床病例均恢复了运动能力，客户满意度极高。
在站立镇静的马匹中，甲状舌骨切除术始终是可行的。该方法未导致术后并发症，并使与THO相关的临床症状得到缓解。
对于受THO影响的马匹，尤其是出现明显前庭功能障碍和共济失调的马匹，应考虑进行站立CHE，以降低全身麻醉恢复相关的风险。
