A Step by Step Guide to Performing a Tension Palatoplasty (Ahern Procedure) and a Maximum Tension Palatoplasty
DOI:
https://doi.org/10.48165/ijvsbt.22.4.41Keywords:
Soft palate, surgery, palatal instability, dorsal displacementAbstract
The surgical procedure referred to as a Tension Palatoplasty, Oral Palatopharyngoplasty or Ahern Procedure was conceived in the late 1980’s. Since then variations in instrumentation, suture patterns and materials have been explored. In addition a two stage Maximum Tension Palatoplasty approach had been developed. Exploration of its use as an adjunct to other upper airways procedures had also been explored.
The procedure had however not been popularised, due to reports of high wound breakdown rates, technical difficulties experienced operating in a confined and relatively distant space and the possibility of creating an oronasal fistula.
This article presents numerous aides and a detailed account of the process, to assist surgeons who wish to attempt the procedure. It also contains suggestions that can hopefully reduce wound breakdown rates and unwanted iatrogenic defects including oronasal fistulas
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References
Ahern, T. J. (1993). Oral palatopharyngoplasty. Journal of Equine Veterinary Science, 13(4), 185–188. https://doi.org/10.1016/S0737-0806(06)81000-2
Ahern, T. (2018). The modified oral palatopharyngoplasty or modified Ahern procedure. World Journal of Veterinary Science, 6, 33–37. https://doi.org/10.12970/2310-0796.2018.06.07
Allen, K. I., & Franklin, S. (2013). Characteristics of palatal instability in Thoroughbred racehorses and their association with the development of dorsal displacement of the soft palate. Equine Veterinary Journal, 45(4), 454–459. https://doi.org/10.1111/evj.12004
Holcombe, S. J., Derksen, F. J., Stick, J. A., & Robinson, N. E. (1999). Pathophysiology of dorsal displacement of the soft palate in horses. Equine Veterinary Journal, 31(Suppl. 30), 45–48. https://doi.org/10.1111/j.2042-3306.1999.tb05186.x
Ahern, T. J. (1993a). Acquired pharyngeal dysfunction (APD). Journal of Equine Veterinary Science, 13(3), 125–128. https://doi.org/10.1016/S0737-0806(07)80056-6
Ahern, T. (2024c). The oropharyngeal seal, the primary mechanism involved in maintaining the soft palate in a ventral position within the nasopharynx of equids: Its role in maintaining a horse's health and well-being, along with surgical approaches that could potentially enhance its function. Indian Journal of Veterinary Sciences and Biotechnology, 21(3), 1–6. https://doi.org/10.48165/ijvsbt.21.3.01
Ordridge, R. M. (2001). The treatment of dorsal displacement of the soft palate by thermal cautery: A review of 252 cases. Proceedings of the World Equine Airway Symposium, 2.
Ahern, T. (2021). Horses are obligate nasal breathers: But does this obligation still apply when a horse's "nasopharyngeal air supply" and with this its "defence through flight" is compromised? World Journal of Veterinary Science, 9, 27–30. https://doi.org/10.12970/2310-0796.2021.09.05
Ahern, T. (2019). Mouth opening during ridden exercise in sports horses: An evasive behaviour, an indication of pain or discomfort or a physical adjustment to facilitate the oral passage of air during inspiratory efforts. World Journal of Veterinary Science, 7, 10–13. https://doi.org/10.12970/2310-0796.2019.07.03
Ahern, T. J. (1993b). Oral palatopharyngoplasty: A survey of one hundred post-operative raced horses. Journal of Equine Veterinary Science, 13(12), 670–672. https://doi.org/10.1016/S0737-0806(06)81554-6
Reardon, R., Bladon, B. M., & Lane, J. G. (2007). Oral palatopharyngoplasty for treatment of horses with signs associated with intermittent dorsal displacement of the soft palate: A case-control study in 78 racing Thoroughbreds. In Proceedings of the Congress of the British Equine Veterinary Association (p. 298). Equine Veterinary Journal Ltd.
Ahern, T. (2024a). Obstructive sleep apnea in people and dogs and an equine perspective. Indian Journal of Veterinary Sciences and Biotechnology, 20(5), 180–184.
Ahern, T. (2019). Upper oesophageal sphincter aplasia in equids: Observations in preoperative patients and a possible association with some cases of dorsal pharyngeal collapse and paradoxical sleep deprivation. World Journal of Veterinary Science, 9, 10–15.
Ahern, T. (2018). Behavioural changes in a ten-year-old gelding that presented with palatal instability, and observations made following an oral palatopharyngoplasty. World Journal of Veterinary Science, 6, 38–41. https://doi.org/10.12970/2310-0796.2018.06.08
Ahern, T. (2024b). Sleep deprivation and unwanted behaviours in a four-year-old Warmblood mare with upper oesophageal sphincter aplasia: A case study. Indian Journal of Veterinary Sciences and Biotechnology, 20(5).
Van Erck, E. (2011). Dynamic respiratory videoendoscopy in ridden sports horses: Effect of head flexion, riding, and airway inflammation in 129 cases. Equine Veterinary Journal, 43(Suppl. 40), 18–24. https://doi.org/10.1111/j.2042-3306.2011.00492.x
Ahern, T. (2005). Maximum tension palatoplasty. Journal of Equine Veterinary Science, 25(2), 46–47. https://doi.org/10.1016/j.jevs.2005.01.004
Spires, V. C., Bourke, J. M., & Anderson, G. A. (1984). Assessment of the efficacy of an abductor muscle prosthesis for treatment of laryngeal hemiplegia in horses. Australian Veterinary Journal, 60(10), 294–299. https://doi.org/10.1111/j.1751-0813.1983.tb02812.x
Lee, S. K., & Lee, I. (2019). Surgical corrections and postsurgical complications of epiglottic entrapment in Thoroughbreds: 12 cases (2009–2015). Journal of Equine Science, 30(2), 41–45. https://doi.org/10.1294/jes.30.41
Woodie, J. B., Ducharme, N. G., Kanter, P., Hackett, R. P., & Erb, H. N. (2005). Surgical advancement of the larynx (laryngeal tie-forward) as a treatment for dorsal displacement of the soft palate in horses: A prospective study, 2001–2004. Equine Veterinary Journal, 37(5), 418–423. https://doi.org/10.2746/042516405774480076
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