What is Ceratohyoidectomy?
A ceratohyoidectomy is a surgical procedure performed by your veterinarian to disconnect the ceratohyoid bone, thereby disarticulating it from adjacent structures in the hyoid when degenerative disease occurs in the hyoid apparatus. This apparatus is critical to functioning of the tongue, pharynx and larynx. The most commonly recognized condition is temporohyoid osteoarthropathy, which results in the abnormal growth of bone structure in the hyoid structures causing ankylosis, fusion, of the temporohyoid joint. The resulting stress on adjoining structures by the immobility of this joint result in fractures and disruption in the hyoid apparatus and surrounding area that result in neurological symptoms. A ceratohyoidectomy, performed under general anesthetic, by a veterinarian, alleviates stress on the hyoid apparatus structures with the fusion of the temporohyoid joint by removing the ceratohyoid bone connections that are contributing to limited movement and friction in the area.
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Ceratohyoidectomy Procedure in Horses
Prior to surgery your horse will be administered antibiotics and nonsteroidal anti-inflammatory medications and possibly antiprotozoal medications if deemed necessary. Horses undergoing this procedure are sedated, administered intravenous anesthesia and then maintained with gaseous anesthetic while vital signs are carefully monitored. Horses are placed in dorsal recumbency, on their back on a surgical table. The skin over the ventral larynx and pharynx is clipped and antiseptically cleaned. An 8-10 cm incision is made over the basihyoid bone and the bone is exposed. The basihyoid-ceratohyoid articulation is isolated and the ceratohyoid disarticulated from the basihyoid bone. Further dissection is performed to manipulate tissue and expose the the connection to stylohyoid bone which is disarticulated using cartilage scissors. Avoiding critical nerves and blood supply is essential so as not to cause damage. Incisions are closed using three layer sutures. Your horse will be supervised as they recover from general anesthetic.
Efficacy of Ceratohyoidectomy in Horses
Ceratohyoidectomy may be successful in reducing stress on the hyoid apparatus posed by fusion of bones in this area due to degenerative diseases and alleviating neurological symptoms. Results are variable, but usually prognosis is fair and recovery is often achieved.
Ceratohyoidectomy Recovery in Horses
The horse should be treated with antibiotics for two to four weeks pre and post-surgery and anti-inflammatories for one to two weeks. Your horse’s incision should be monitored for signs of infection and bleeding. Recovery from neurological symptoms should be carefully observed and supportive care provided as needed.
Most horses experience a reduction in symptoms and pain and can return to eating within three to five days.
Cost of Ceratohyoidectomy in Horses
The cost of ceratohyoidectomy in horses depends on the cost of living in your area and availability of facilities and expertise to perform the procedure. This procedure can vary in cost from $1,000 to $2,000.
Horse Ceratohyoidectomy Considerations
Hemorrhage and damage to facial nerves resulting in facial paralysis are possible if care is not taken during the surgical procedure. Risk from anesthetic administration and infection is present as with all surgical interventions, but due to the location and processes involved in ceratohyoidectomy these risks are particularly significant. Secondary complications such as aspiration pneumonia should be checked for.
Ceratohyoidectomy Prevention in Horses
It is unlikely that the degenerative condition necessitating ceratohyoidectomy in horses can be avoided, however prompt attention to ear and guttural pouch infections may decrease disorder in this area, resulting in better health for hyoid structures making them less susceptible to disease.