#upper airway

[publicwellnessgroup-blog]

Sleep Apnea- Dealing with the Disorder | PublicWellness Group

If your partner complains that you snore during your sleep, or if you wake up in the morning feeling tired and grouchy, you may have a common sleep disorder

[grade-applications-hws]

You Differentiate That Something Ad's On tour to Happen

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[thescienceofequus]

Subepiglottic cyst snaring surgery

As mentioned in our previous What’s Your Diagnosis post.

The mass being removed in this video is a subepiglottic cyst, a fluid-filled mass that sits under the epiglottis.

The triangular structure on top of the mass is the tip of the epiglottis, which in a horse lies flat in front of the larynx (the horse was lying on its back, so we flipped the video upside down to give you a better perspective).

Subepiglottic cysts are most common in young Thoroughbreds and Standardbreds. They can cause difficulty eating, drinking and exercise intolerance and can result in coughing or even pneumonia if foreign material is inhaled. 

Subepiglottic cysts can be very difficult to detect, and removal is the only treatment. The subepiglottic cyst removal snaring technique in this video was developed by the surgeons at Hagyard. The horses in both this post and the last recovered fully after their cysts were removed.

- Hagyard Equine Medical Institute   

[thescienceofequus]

Dorsal Displacement of the Soft Palate (DDSP) 

(Can be more commonly referred to as “choking down” or “flipping the palate.”)

[ Anatomy ref can be found HERE ]

Horses with intermittent DDSP are exercise intolerant and most (70-80%) affected horses will make an abnormal noise during exhalation at fast work. The displaced soft palate billows dorsally during exhalation as air flows beneath the soft palate. Horses often produce a “snorting” noise when the soft palate is displaced, and this is caused by a low frequency fluttering of the caudal margin of the soft palate during expiration. However, in approximately 30% of horses with DDSP, noise is not reported. The caudal edge of the soft palate in each horse has a different stiffness, and this may be why 20-30% of horses are “silent displacers.” Dorsal displacement of the soft palate could still be considered as a possible diagnosis in horses with a sudden decrease in performance and no history of respiratory noise. This disease is more common in racehorses, especially 2 to 4-year-olds, but in Europe, it is also common in older National Hunt racehorses. It is an uncommon disease of hunters and western pleasure horses, but does affect horses that carry their head and neck in a flexed position, such as upper level dressage horses and saddlebreds.

Dorsal displacement of the soft palate is an expiratory upper airway obstructive syndrome that can cause increased respiratory impedence, decreased minute ventilation, hypoxia, and hypercarbria. […] During inhalation the soft palate rests dorsal to the epiglottis and does not cause obstruction because inspiratory pressures maintain it in a relatively stable position on the floor of the nasopharyinx. [Laying flat along the bottom of the airway.] However, during exhalation the soft palate billows dorsally into the nasopharyngeal lumen, thus diverting some of the flow of air through the oropharynx and the mouth. [ The palate billows to partially block the airway. ] […] Some horses suffering from DDSP exhibit the characteristic sign of mouth breathing during exhalation, recognized by fluttering of the cheeks as air is diverted underneath the soft palate and through the mouth.

The cause of intermittent DDSP is unknown, but many theories exist to explain the etiology of this condition which is likely multifactorial. Some theories focus on dysfunction of the nerves and muscles that control the soft palate, and others concern the stability and the proximity of the epiglottis and larynx to the soft palate.*

Surgical options include:**

Staphylectomy

Sternothyroid myectomy

Combined staphylectomy and sternothyroideus tenectomy

Epiglottic augmentation

Partial sternothyroidectomy and laser cautery of the caudal aspect of the soft palate

Laryngeal tie-forward

[ SOURCE - Equine Respiratory Medicine and Surgery ]

* There is more. I can add the infomation upon request

** I skipped non-surgical treatment options and the descriptions/images of the surgeries. Again, let me know if this is information you would like, and I can transcribe it & add it to this post.

[thescienceofequus]

Abnormal findings in upper airway endoscopy of the horse:

Row 1 – L: Entrapped epiglottis R: Granuloma off the left arytenoid cartilage

Row 2 – L:  Arytenoid chondritis (inflammation of both arytenoid cartilages) R:  Recurrent laryngeal neuropathy. (Roarer)

Row 3 – L:  Pharyngeal cyst R: Progressive ethmoid hematoma

[ Anatomy Image Source ] 

And here’s a neat video of a full upper-airway endoscopic exam: 

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This is video of a complete upper airway endoscopic examination at rest (horse standing still).

Posted by Rood & Riddle in Saratoga on Sunday, April 26, 2015

[ebestproducts]

Snoring Driving You Insane?

Are you keeping up loved ones with your snoring? Are you embarrassed to sleep next to friends as you fear they will mock you? Do you just want to get rid of your snoring habits once and for all? Fear not as there are many remedies and surgical procedures that can sort you out! Snoring...

http://www.ebestproducts.com/2012/11/snoring-driving-insane/