Ceratohyoidectomy for Management of Unilateral and Bilateral Temporohyoid Osteoarthropathy: Long-Term Outcome in 33 Equids

Temporohyoid osteoarthropathy is a disease affecting the temporohyoid joint in equids caused by local inflammation and/or degeneration, leading to neurological deficits ranging from mild signs that affect performance to significant, acute neurological deficits such as facial nerve paralysis or vestibular signs. Multiple surgical treatment options are available, and while treatment has historically been performed unilaterally on the side of the clinical signs, advances in diagnostic imaging have highlighted the occurrence of bilateral disease of the temporohyoid joints, warranting evaluation of bilateral surgical treatment. The objective of this study is to report the findings, surgical complications, and outcomes of both unilateral and bilateral ceratohyoidectomy in 33 equids diagnosed with THO. This study found that there was no significant difference in outcome based on which procedure was performed, but that increased age and longer duration of clinical signs were associated with decreased likelihood of horses returning to work or showing clinical improvement. Overall, this study reports 84% survival to long term; 86% cases showed improvement, with 38% showing complete resolution of signs, 62% returned to the previous level of exercise, and 77% returned to work at the same or lower level.