equis - Articles
Larynx: epiglottic entrapment
Introduction
- Loose mucosal folds on ventral epiglottis - fold over rostrodorsal aspects of epiglottis.
- Apex and some of the body of the epiglottis become trapped in the mucosa.
- Mucosal folds may become ulcerated and granulomatous.
- Signs: vary from asymptomatic to loud upper respiratory noises and exercise intolerance and dysphagia.
- Diagnosis: history, signs, endoscopy, radiography.
- Treatment: depends on severity. None, NSAIDs or surgery.
- Prognosis: surgery generally successful.
Presenting signs
- Respiratory stridor.
- Exercise intolerance.
- Coughing.
- Nasal discharge.
- Asymptomatic.
Acute presentation
- See Presenting signs.
Geographic incidence
- Worldwide.
Breed/Species predisposition
- Standardbred Standardbred.
- Chilean Crillo ponies.
- Throughbred Thoroughbred.
- Also reported in adult non-racehorses.
Cost considerations
- Cost of treatment.
Special risks
- Intubation for general anesthesia may be more difficult.
Pathogenesis
Etiology
- Entrapment of epiglottis in loose mucosal folds.
Predisposing factors
Specific
- Conditions which can predispose to epiglottic entrapment are:
- Epiglottic hypoplasia.
- Permanent dorsal displacement of the soft palate Soft palate: dorsal displacement.
- Subepiglottic cyst Epiglottis: cyst - subepiglottic.
- Epiglottitis Epiglottis: epiglottitis - acute.
Pathophysiology
- Loose mucosal folds on ventral surface of epiglottis → fold up over rostrodorsal aspect of epiglottis → epiglottis becomes trapped in these mucosal folds → inflammation and ulceration of mucosa, epiglottis and soft palate.
- Permanent or intermittent.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Strand E et al (2012) Relative prevalence of upper respiratory tract obstructive disorders in two breeds of harness racehorses (185 cases: 1998-2006). Equine Vet J 44 (5), 518-523 PubMed.
- Saulez M N & Gummow B (2009) Prevalence of pharyngeal, laryngeal and tracheal disorders in Thoroughbred racehorses, and effect on performance. Vet Rec 165 (15), 431-435 PubMed.
- Franklin S H (2008) Dynamic collapse of the upper respiratory tract: A review. Equine Vet Educ 20 (4), 212-224 VetMedResource.
- Russell T & Wainscott M (2007) Treatment in the field of 27 horses with epiglottic entrapment. Vet Rec 161 (6), 187-189 PubMed.
- Wishaupt M A, Kastner B R, Feige K, Schmid M & Auer J A (1998) Airflow characteristics and alteration of stride-respiratory coupling in a Trakehner stallion with intermittent epiglottic entrapment. Equine Vet Educ 10 (4), 172-176 VetMedResource.
- Dixon P M (1995) A review of the role of the epiglottis in equine upper airway obstruction. Equine Vet Educ 7 (3), 131-139 VetMedResource.