Intro to upper respiratory noise

Question 1

List some reasons for treating URT noise in horses

Answer 1

Dyspnoea
Cosmetics
Poor performance- due to reduced O2 delivery
dysphagia

Question 2

Describe how to approach diagnosis of URT noise

Answer 2

History
examination of the URT at rest
dynamic examination
static respiratory endoscopy
overground dynamic endoscopy

Question 3

List 3 conditions which can affect external nares of horse

Answer 3

Epidermal inclusion cysts (atheromas)- cosmetic
Redundant alar folds
Lacerations affecting nostrils

Question 4

Name a congenital condition that can affect the external nares

Answer 4

wry nose- seen in newborn foals
most euthanised

Question 5

List the caudal group of paranasal sinuses

Answer 5

Caudal maxillary
Dorsal conchal
Ethmoidal
Frontal
Sphenopalatine

Question 6

Name the rostral group of paranasal sinuses

Answer 6

Rostral maxillary
Ventral conchal

Question 7

Which teeth roots can be found in the maxillary sinuses

Answer 7

4th, 5th and 6th cheek teeth roots

Question 8

which tooth root forms the rostral wall of the rostral maxillary sinus

Answer 8

3rd cheek tooth root

Question 9

List 3 indications for sinus surgery

Answer 9

Expansive lesions in paranasal sinus
Primary sinusitis
Severe trauma of facial bones

Question 10

List 3 advantages of a standing sinus surgery

Answer 10

no anaesthetic risks
less haemorrhage
well tolerated by horse

Question 11

List 3 radiographic findings seen with tooth root infection

Answer 11

tooth more radiolucent
loss of definition of lamina dura
change in periapical region appearance

Question 12

List the 3 masses of the nasal passages

Answer 12

fungal granuloma
neoplasia
ethmoid haematoma

Question 13

What must we consider before sinus surgery

Answer 13

which sinus is affected
know anatomical landmarks for each region
consider endoscopic/ laser surgery first as minimally invasive
standing surgery- number of advantages

Question 14

List 2 conditions which cause noise in the upper respiratory tract of horses

Answer 14

RLN- recurrent laryngeal neuropathy (laryngeal hemiplegia/ roaring)
DDSP- dorsal displaced soft palate

Question 15

what happens in recurrent laryngeal neuropathy

Answer 15

paralysis of the larynx
gradual deterioration of the nerve fibres in the larynx –> cartilage of the larynx can collapse

Question 16

what side is paralysis more likely to be on in RLN?

Answer 16

left

Question 17

List the 3 most commonly used methods of surgical correction used for RLN

Answer 17

Tie back- prosthetic laryngoplasty
Ventriculectomy
Ventriculocordectomy

Question 18

What is DDSP?

Answer 18

dorsal displacement of soft palate

Question 19

How does DDSP present? How would you diagnose it?

Answer 19

Obstruction when the horse breaths out because the soft palate acts as a parachute
results in a rise in blood CO2 and exercise intolerance
gurling and growling noises when exercising

endoscopy to diagnose

Question 20

What is the gold standard surgery for correction of DDSP?

Answer 20

Tie forward

Question 21

Staphylectomy is not recommended as standard for DDSP, but in which cases might it be appropriate? what is the risk?

Answer 21

for horses with a mass along the caudal free margin of the soft palate

dysphagia is a risk if too much is resected

Question 22

Describe how to diagnose arytenoid chondritis

Answer 22

endoscopy (resting)
palpation- rounded muscular process

Question 23

describe how to treat arytenoid chondritis

Answer 23

Medical:
antimicrobials
anti-inflam
+/- Surgical - local excision or arytenoidectomy (if failure of medical management

Question 24

List 3 reasons to perform surgery on the guttural pouch

Answer 24

tympany- guttural pouch fills with air
Empyema - filled with pus
chondroids

Question 25

What is the difference between Tracheotomy and Tracheostomy

Answer 25

Tracheotomy (temporary)
Tracheostomy (permanent)

Question 26

Describe how we treat nala passage masses

Answer 26

transendoscopic removal

Question 27

How can we identify sinus issues on radiograph

Answer 27

we can look for ‘soft tissue’ or ‘fluid’ opacity in the sinuses

Question 28

define exodontia

Answer 28

extraction of a tooth

Question 29

what noise occurs when there is dorsal displacement of the soft palate

Answer 29

expiratory noise

Question 30

what noise occurs when there is is laryngeal paralysis

Answer 30

inspiratory noise

Question 31

List 4 possible complications of laryngeal surgery

Answer 31

dysphagia
aspiration pneumonia
excessive abduction
implant failure

Question 32

How can we diagnose cleft palate

Answer 32

on endoscopy

Question 33

List 3 clinical signs of cleft palate

Answer 33

nasal reflux of milk/food material
aspirational pneumonia
poor athletic function

Question 34

what is arytenoid chrondritis

Answer 34

infection or inflammation of the arytenoid cartilages

Question 35

where is a tracheotomy performed

Answer 35

in the cranial or mid third of the neck - midline - between and parallel to cartilage rings

Question 36

Describe how to treat guttural pouch empyema

Answer 36

lavage via a foley catheter

Question 37

Describe how to treat guttural pouch chondroids

Answer 37

basket removal
lavage or surgery

Question 38

Describe how can we treat a guttural pouch tympany

Answer 38

create a fenestration of the median septum
resect the plica salpingopharangeus or create a salpingopharyngeal fistula