Epiglottic retroversion in a Lusitano cross gelding

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A ten-year-old Lusitano cross gelding presented to Cornell Equine Orthopedic Surgery Service on April 11, 2013 for further evaluation and correction of epiglottic retroversion. The patient had a two-year history of exercise intolerance and abnormal upper airway noise when exercising or cross-tied. The noise was exacerbated with flexion at the poll. He was previously diagnosed with epiglottic entrapment and was treated with a conservative aryepiglottic fold resection. The patient failed to improve post-operatively and was referred to Tufts University for dynamic treadmill upper airway endoscopy. He was diagnosed with epiglottic retroversion and was referred to Cornell for surgical correction of his disorder. Pre-operative resting upper airway endoscopy showed the rostral tip of the epiglottis to be narrow and slightly elevated. Laryngeal anatomy and function at rest were otherwise normal. The patient was sedated, and the thryoepiglottic ligament was locally anesthetized. Transcutaneous ultrasonography ventral to the larynx and upper airway endoscopy were used to identify the space between the base of the epiglottis and the rostral thyroid cartilage. A diode laser was used to deposit energy between the base of the epiglottis and the rostral thyroid cartilage, with the goal of partially fusing the two structures to stabilize the epiglottis. Post-operative resting upper airway endoscopy revealed moderate swelling at the base of the epiglottis and normal laryngeal function. The patient was rested and fed at shoulder-height for six weeks post-operatively. He then was slowly transitioned into regular work and has reportedly been successful in dressage and low-level eventing.
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Senior seminar paper
Seminar SF610.1 2014
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Horses -- Diseases -- Treatment -- Case studies; Horses -- Surgery -- Case studies
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