Upper airway conditions can significantly impact a horse’s athletic performance. Noise during exercise, reduced exercise tolerance, and respiratory distress are common presentations. Several surgical options are available to address these conditions and return horses to their competitive potential.
Common Conditions
Recurrent Laryngeal Neuropathy (Roaring)
The most common upper airway condition in performance horses. The left arytenoid cartilage loses its ability to fully abduct during exercise, causing partial obstruction and the characteristic “roaring” sound. Primarily affects large-breed horses.
Dorsal Displacement of the Soft Palate (DDSP)
The soft palate intermittently displaces above the epiglottis during exercise, causing a characteristic gurgling sound and sudden loss of performance. Can be intermittent and challenging to diagnose without dynamic endoscopy.
Epiglottic Entrapment
The aryepiglottic fold engulfs the epiglottis, altering airflow dynamics. Usually identified on resting endoscopy.
Diagnosis
- Resting endoscopy — initial screening of upper airway anatomy
- Dynamic (overground or treadmill) endoscopy — evaluates airway function during exercise; essential for conditions like DDSP that may only manifest during work
- Ultrasonography — can assess laryngeal function in some cases
Surgical Options
Laryngoplasty (Tie-Back)
The standard treatment for recurrent laryngeal neuropathy. A prosthetic suture is placed to hold the arytenoid cartilage in an abducted position, restoring airway diameter during exercise. Often combined with a ventriculectomy.
Soft Palate Procedures
Several techniques exist to address DDSP including cautery, palate stiffening procedures, and tie-forward surgery. The approach depends on the underlying cause.
Epiglottic Entrapment Correction
Typically corrected using transendoscopic laser surgery — a minimally invasive standing procedure.
Post-Operative Care
Recovery protocols vary by procedure. Laryngoplasty patients require careful dietary management and gradual return to exercise. Most horses can return to performance within 2-3 months of uncomplicated airway surgery.
Outcomes
Success rates for upper airway surgery are generally good when cases are properly selected and diagnosed. Accurate pre-surgical diagnosis — particularly with dynamic endoscopy — is the key to matching the right surgical procedure to the specific condition.