Clinical update: transendoscopic laser surgery for treatment of epiglottic entrapment, Nd: YAG and 808-nm diode laser applied individually and in combination

摘要

Hospital records reviewed from 1986-1998 determined that 18 horses were presented for correction of epiglottic entrapment by the aryepiglottic fold. All horses had a history of an abnormal respiratory noise and/or exercise intolerance. In conjunction with epiglottic entrapment, 10 horses had dorsal displacement of the soft palate. Initial confirmation of the epiglottic entrapment was made by endoscopic examination. In addition, 3 horses had radiographs taken of the larynx and pharyngeal region to determine to length of the epiglottis. Laser surgical treatment was performed on the horses in a standing position under sedation. The treatment consisted of axially dividing the aryepiglottic fold from the base of the epiglottis to the tip or beyond by means of a laser fiber introduced through the biopsy channel of an endoscope. The Nd: YAG laser was applied transendoscopically to 11 horses using free fiber technique. Three horses received transendoscopic laser correction using the 808-nm diode laser with the fiber in contact configuration. A combination of both 808-nm diode laser and Nd: YAG lasers were used to facilitate correction in the last 4 horses. Partial re-entrapment occurred in 2 out of the 3 cases in which the 808-nm diode laser was used as a single modality for correction. This did not occur in the horses that received either the Nd: YAG laser treatment or Nd: YAG laser treatment in combination with the 808-nm diode laser. Horses that received either 808-nm diode laser irradiation alone or 808-nm diode laser irradiation in combination with Nd: YAG laser appeared to have less swelling than those that received only Nd:YAG irradiation.