Epiglottic entrapment

What is epiglottic entrapment?

Epiglottic entrapment is a condition affecting the horse’s upper airway, where a thin fold of tissue (the aryepiglottic fold) becomes trapped over the epiglottis. The epiglottis is a small, leaf-shaped structure that normally sits above the soft palate and helps keep the airway open during breathing and exercise. When this fold of tissue gets stuck over the epiglottis, it can partially block the airway and cause abnormal respiratory noise, especially during work.

What are the signs?

A gurgling, wheezing, or whistling sound during exercise
Reduced performance, particularly in racehorses or sport horses
In some cases, mild coughing or difficulty maintaining speed
Occasionally, the condition is intermittent and may come and go

What causes epiglottic entrapment?
This condition is often due to the shape or length of the epiglottis or increased laxity of the surrounding tissue. Inflammation of the airway can also contribute. Some horses are born with a conformation that makes them more prone to this problem, while in others it may appear after strenuous exercise or airway irritation.

How is it diagnosed?
Diagnosis is made using an upper airway endoscopy, where a small camera is passed through the horse’s nostril to visualize the larynx and epiglottis. This allows the veterinarian to confirm that the epiglottis is trapped beneath the fold of tissue.

Treatment options
The most common treatment is a simple surgical procedure to cut the entrapping tissue (called a “transsection” or “division” of the aryepiglottic fold). This can often be performed on a standing horse under sedation using a laser or a special hook via an endoscope. In some cases, the procedure is performed under general anesthesia.

Recovery is typically quick, and most horses can return to light work within 2–3 weeks and full training shortly after, depending on the discipline and the extent of the procedure.

Prognosis
The prognosis is generally excellent, especially when there are no other underlying airway abnormalities. Some horses may experience recurrence, but this is relatively uncommon when the tissue is fully divided.

Key points for horse owners

Epiglottic entrapment is a common cause of upper airway noise in performance horses.
It can often be treated quickly and effectively with a minor surgical procedure.
Early diagnosis via endoscopy is important to differentiate it from other airway conditions, such as laryngeal hemiplegia (“roaring”).

If you notice unusual respiratory noise or decreased performance in your horse, it’s recommended to have an airway examination performed to determine the cause and the best treatment plan.