Page 158 - Manual of Equine Field Surgery

154 HEAD AND NECK SURGERIES

Postoperative C,ar~ for Staphylectomy phagia if too much of the caudal palate is removed

Procedures . .. . and granulation tissue at the exposed edge of the

palate.

Exercise Restridions: The horse should be

rested in a stall with controlled handwalking only

for 2 weeks to allow the inflammation of the soft

palate to subside. The horse may then return to COMMENTS

its normal activity.

Medications: Broad-spectrum antibiotics and DDSP is a common cause of poor performance in

nonsteroidal antiinflammatory drugs are adminis- racehorses, but it also occurs in other types of per-

tered for 2 to 5 days depending on the amount formance horses, particularly those that have

of postoperative drainage and Iota! inflammation. exaggerated flexion at the poll during work. DDSP

Suture Removal: Laryngotomy incisions may be is one of the common causes of noise at exercise

left to heal by second intention.

Other: The incision site is cleaned at least once and the noise is typically characterized as a "gur-

daily with moistened sterile sponges. Petrolatum gling" sound, generally loudest on expiration. It is

is applied around the incision to minimize often a diagnosis by exclusion of other common

scalding. causes of noise at exercise or decreased perfor-

mance. Horses with DDSP often have significant

EXPECTED OUTCOME

The incision should heal completely within 2 to

3 weeks with minimal scarring. Previous reports

have indicated a 50°/o to 85o/o chance for return to

normal activity following the various versions of

sternothyrohyoideus rnyectomy.v':" The progno-

sis for horses with intermittent dorsal displace-

ment to return to normal activity following

staphylectomy is about 60%.4'15•16 Combinations

of these procedures have been reported to

improve the prognosis.P" Horses with persistent

DDSP or a hypoplastic epiglottis with DDSP have

a poor prognosis. In cases with a hypoplastic A

epiglottis, a partial staphylectomy with or without

epiglottic augmentation may be a better surgical

option.

COMPLICATIONS

Following myectomy-tenectomy procedures, the

complications are few but can include seroma or

hematorna formation, incisional infections, and

reuniting of the severed ends of the muscles

through scar formation. Serornas and hematomas

are best treated by controlling bleeding at the time

of surgery, adequate counterpressure applied to

the wound postsurgery, and limiting exercise in B

the immediate postoperative period. There may Figure 25-14 A. Endoscopic view of normal equine

be a cosmetic defect at the site of muscle resec- larynx. B, Endoscopic view of equine larynx with dorsal

tion. Staphylectomy complications include dys- displacement of the soft palate.