Greet T R
Beaufort Cottage Stables, Newmarket, Suffolk, UK.
Equine Vet J. 1995 Mar;27(2):122-6. doi: 10.1111/j.2042-3306.1995.tb03047.x.
Thirty eight horses with epiglottal entrapment were examined. In 29 the dorsally displaced mucosa was split axially with a curved hook knife, per nasum. The condition was also treated by subepiglottal mucosal resection (4 horses) and solely by the administration of an anti-inflammatory throat spray (4 horses). All surgical cases were treated with an anti-inflammatory throat spray and parenteral phenylbutazone. Those horses treated via a laryngotomy incision were box rested until the laryngotomy incision healed. The other horses were restricted to walking and trotting exercise for 10 days before endoscopic re-assessment. If the condition had resolved by this stage the horse was then returned to full exercise. Epiglottal entrapment was alleviated in 22 horses treated by axial section but it recurred in 4 and 3 cases were lost to follow up. Two of 4 cases were treated successfully but mucosal resection and 2 of 4 cases by Nd:YAG laser. Three out of the 4 horses treated medically also recovered. Of the 38 horses, 6 required a second operation and 2 had a third surgical procedure. Of the horses treated by axial section of the displaced mucosa, 14 ran successfully without a respiratory sound or obstruction and 4 won races. In conclusion, using the hook knife inserted via the nasal passages offers a safe, relatively inexpensive and successful method of treating epiglottal entrapment.
对38匹患有会厌嵌顿的马进行了检查。在29匹马中，经鼻用弯形钩刀轴向切开背侧移位的黏膜。4匹马采用会厌下黏膜切除术进行治疗，4匹马仅给予消炎咽喉喷雾剂治疗。所有手术病例均给予消炎咽喉喷雾剂和非肠道注射苯基丁氮酮治疗。那些通过喉切开术切口治疗的马被关在马厩休息，直到喉切开术切口愈合。其他马在进行内镜复查前10天限制进行行走和小跑运动。如果在此阶段病情已经缓解，马则恢复全面运动。22匹经轴向切开治疗的马的会厌嵌顿得到缓解，但4例复发，3例失访。4例中的2例通过黏膜切除术成功治疗，4例中的2例通过Nd:YAG激光治疗。4匹接受药物治疗的马中有3匹也康复了。在这38匹马中，6匹需要进行第二次手术，2匹进行了第三次手术。在经轴向切开移位黏膜治疗的马中，14匹成功参赛，没有呼吸音或梗阻，4匹赢得了比赛。总之，经鼻插入钩刀提供了一种安全、相对便宜且成功的治疗会厌嵌顿的方法。
