Lumsden J M, Stick J A, Caron J P, Nickels F A
Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824.
J Am Vet Med Assoc. 1994 Sep 1;205(5):729-35.
Medical records of 51 horses with epiglottic entrapment were reviewed, and the outcome after surgical treatment was evaluated by use of results from a survey of owners and from race records. Horses with epiglottic entrapment and no additional problem (uncomplicated) of the nares, nasal passages, pharynx, or larynx (upper airway) that were treated by transoral axial division (group 1) or resection via laryngotomy (group 2), and horses with epiglottic entrapment complicated by an additional upper airway abnormality (group 3) were compared. The cost of treatment, duration of hospitalization, time to first race start after surgery, and complication rate were significantly (P < 0.05) less in horses in group 1, compared with those in horses of group 2. Owner survey indicated that a significantly greater percentage (82%) of horses in group 1 had a successful outcome after transoral axial division, compared with that (27%) of horses in group 2. Analysis of race records indicated that performance was similar between horses in groups 1 and 2, and significantly more horses with an additional upper airway lesion (group 3) failed to return to racing than did horses with uncomplicated epiglottic entrapment (groups 1 and 2). Transoral axial division of the ary-epiglottic fold is recommended as an appropriate treatment for uncomplicated epiglottic entrapment. Resection via laryngotomy should be reserved for treatment of epiglottic entrapment associated with excessively thick and scarred aryepiglottic folds and for intermittent epiglottic entrapment in horses for which surgical correction is deemed appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)
回顾了51匹会厌嵌顿马的病历，并通过对马主的调查结果和赛马记录来评估手术治疗后的结果。比较了通过经口轴向分离术治疗（第1组）或喉切开术切除治疗（第2组）的、无鼻孔、鼻道、咽或喉（上呼吸道）其他问题（无并发症）的会厌嵌顿马，以及伴有上呼吸道其他异常的会厌嵌顿马（第3组）。与第2组的马相比，第1组马的治疗费用、住院时间、术后首次参赛时间和并发症发生率显著更低（P < 0.05）。马主调查显示，第1组中经口轴向分离术后成功的马的比例（82%）显著高于第2组（27%）。对赛马记录的分析表明，第1组和第2组马的表现相似，与无并发症的会厌嵌顿马（第1组和第2组）相比，伴有上呼吸道其他病变的马（第3组）未能重返赛场的比例显著更高。推荐对无并发症的会厌嵌顿采用经口轴向分离会厌襞作为合适的治疗方法。喉切开术切除应保留用于治疗与会厌襞过厚和瘢痕化相关的会厌嵌顿，以及对认为适合手术矫正的马的间歇性会厌嵌顿。（摘要截短于250字）
