Abstract
ObjectiveTo describe a resection technique of the alar folds in the standing horse.Study designRetrospective case study.AnimalsEight Standardbred racing trotters.MethodsHorses in which alar fold collapse had been diagnosed between 2017 and 2018 were included in this study. All horses underwent alar fold resection under standing sedation and regional anesthesia with a bipolar electrosurgical open sealer/divider device (LigaSure). Intraoperative and postoperative complications were recorded. A Wilcoxon signed‐rank test was used to compare differences in median prize money earning pre‐surgery and post‐surgery (P < .05).ResultsThe surgical procedure was short (20‐30 min), with minimal (1/8) to no (7/8) bleeding and was well tolerated in all cases. Complete resection of the alar folds along with 3 to 5 cm of the ventral conchal cartilage was achieved. No complications were observed post‐surgery with satisfactory second intention healing, allowing return to training/racing within 3 to 6 weeks post‐surgery in all cases. Median earnings post‐surgery increased (P = .03) compared with pre‐surgery.ConclusionAlar fold resection with bipolar electrosurgical energy offered a good alternative to the traditional surgical approaches performed under general anesthesia. The surgery significantly improved race earnings and performance while avoiding the risk associated with general anesthesia and offered a short and complication‐free rehabilitation period.Clinical impactThis study describes a surgical technique offering a novel approach to resection of the alar folds in the standing horse.
Highlights
Alar folds (AF) are mucocutaneous folds located dorsorostrally in the nasal cavities, creating a divide between the true nostril and a smaller upper diverticulum known as the false nostril
One horse was found to have dorsal displacement of the soft palate (DDSP) and was treated simultaneously with laser palatoplasty. Another horse was found to have a mild degree of axial deviation of the aryepiglottic folds (ADAF)
This study describes a novel minimally-invasive surgical technique for the resection of redundant/unstable AF in the standing horse, its surgical outcome, and impact on the racing performance of eight trotter racehorses
Summary
Alar folds (AF) are mucocutaneous folds located dorsorostrally in the nasal cavities, creating a divide between the true nostril and a smaller upper diverticulum known as the false nostril. Alar fold collapse occurs in cases in which redundant size of the AF3 or failure of the transversus nasi muscles action allows entry of air in the false nostrils that causes flaccidity of the AF and partial obstruction of the nasal cavities.[1] Alar fold collapse usually causes a continuous vibrating/buzzing noise, usually present in both expiration and inspiration,[4] associated with elevated expiratory nasopharyngeal pressures.[5] This condition is a known cause for poor performance in equine athletes; AF collapse was diagnosed in 11% of Norwegian standardbreds examined for noise/exercise intolerance.[6] After surgical resection of the AF in horses in which AF collapse was diagnosed, the expiratory nasopharyngeal pressure improved to reported normal levels.[5]. The objective of this study was to describe a minimally invasive technique allowing complete resection of the AF via the natural orifice performed under sedation and local anesthesia (LA) with bipolar electrosurgical energy
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