Experiences in treatment of epiglottal entrapment using a hook knife per nasum.

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.