end of week 6 at Browns

Rain keeps pouring down but we keep working!

Do you guys know the solution to fixing a "roar" in a horse, or otherwise known as laryngeal paralysis? I bet the first thing that comes to mind is a tie back in which suture is placed to physically "tie back" the paralyzed arytenoid. Tie backs are performed on horses that undergo strenuous exercise and need maximum air intake at all times, such as thoroughbred racehorses. However, here at Brown we see a lot more pleasure horses as well as draft pulling horses. Since these horses don't need maximum oxygen intake at high speeds, Dr. Brown performs a ventricular chordectomy on all of them. This procedure isn't as good at opening the airway back up but it gets rid of the roar nonetheless, and for horses that aren't running high speeds its the perfect choice. It is a standing procedure with no suture placed, which makes it safer on the horse as well. Using a scope to visualize what is being done, Dr. Brown makes an incision between the jaw bones, in the throat, right at the level of the arytenoids. He then takes out the saccules that line the ventricles, as well as removes the vocal folds; when this tissue heals, it scars down, creating tension on the paralyzed arytenoid, to keep it from flapping in the airway and causing noise. He removes both sides to assure a tight scar throughout. 

In this image, you can see what is being done on the screen; there is a hemostat clamping off a saccule, ready to be removed! We do this surgery about 2-3 times a week, because he is very efficient at it and the success rate is tremendous! 

Another fun case was a horse that presented 3 legged lame due to a quarter crack. This crack was very severe and his lameness was well justified! Dr. Brown cut away the dead hoof and passed wire from side to side to try and bring the crack back together. He also filled the back side of the heel with epoxy glue (which hardens into plastic-like consistency) to make sure that the horse is stepping on his heel more to prevent rotation of P3 while he is healing. 

Thanks for reading this week!