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  Discussion on Long-term success of tie-back surgery
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Posted on Thursday, Jan 6, 2000 - 7:34 pm:

Hi Dr. O!--Hope I've done my research better this time.

I just purchased a 17-year-old Appendix/TB eventer schoolmaster for my daughter to train on. He's in superb shape for his age. Two years ago, at the age of 15, he had the tie-back surgery for a chronic roaring problem. The surgery was successful, and his physical condition improved markedly, the whole shape of his body changing (he had evented to prelim level on a small fraction of the oxygen he should have been getting, so is a real trooper). Occasionally he will cough when he starts to canter, then coughs out the mucus and continues schooling uneventfully. When the previous owner showed him, she would squirt a syringe of warm water down his throat when she tacked up and this cleared the mucus out. I have two questions: 1) Is this syringe treatment a safe option? 2) When we vetted him out prepurchase, the vet said that the chances of the tie-back tearing loose were greatest in the first year after surgery, and that the fact he had had no complications for two years boded well for the future. Is this your feeling as well? And if the flap were to tear loose, would you recommend further surgery at his age? He is quite a horse and this is his only major medical issue.

Posted on Friday, Jan 7, 2000 - 1:18 pm:

Hello Zoe,
Good questions Zoe,
1) Yes.
2) Yes. Though I cannot find any specific statements of failure rate, a retrospective study of cases 2 to 5 years old do not mention failure of a previously successful prosthesis as one of the complications encountered. Whether to repeat the surgery would depend on the endoscopic evaluation following the tear. They would need to look to see if there is enough healthy tissue to hold another suture tie back. Second surgeries have been successful. If not you could have the partial arytenoidectomy that is talked about in the article.
DrO

Posted on Monday, Jun 3, 2002 - 9:37 pm:

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