Upper Airway Surgery

Upper airway disorders are a common cause of reduced performance in horses. Audible breathing noises—especially during exercise—are often the first sign of an anatomical or functional issue affecting structures from the nostrils to the guttural pouches. Surgical treatment is only considered after thorough diagnostics and when conservative measures have been exhausted.

At Hanseklinik, we follow a comprehensive approach combining advanced imaging, functional diagnostics, and years of surgical experience. Many procedures can be performed minimally invasively while the horse remains standing and sedated.

Table of Contents:

Causes

The conditions that may require upper airway surgery are diverse and may involve the following areas:

  • Nostrils & nasal passages: e.g. nasal alar collapse, sebaceous cysts (atheromas), deviated nasal septum
  • Nasal cavity & sinuses: e.g. polyps, cysts, ethmoid hematomas, sinusitis, tumors
  • Soft palate & pharynx: e.g. DDSP (dorsal displacement of the soft palate), cleft palate, pharyngeal collapse
  • Guttural pouches: e.g. mycosis, empyema, chondritis, temporohyoid osteoarthropathy (THO)
  • Larynx: e.g. recurrent laryngeal neuropathy, cartilage disorders, collapse

Symptoms

  • Metallic “roaring” noise during inspiration under exercise (“whistling”)
  • Gurgling, snoring, or fluttering during inhalation or exhalation
  • Unilateral nasal discharge
  • Exercise intolerance or early fatigue
  • Labored breathing or distress
  • Headshaking or head tilting
  • Difficulty eating in some cases

Course of Disease

If left untreated, upper airway disorders may become chronic and significantly reduce the horse’s well-being and performance. Some conditions (e.g. guttural pouch mycosis, tumors) can progress rapidly and become life-threatening. Early diagnosis greatly improves outcomes, especially in functional issues like laryngeal paralysis.

Diagnosis

To accurately identify the cause of upper airway problems, we use a combination of modern diagnostic techniques:

  • Dynamic (overground) endoscopy under exercise conditions
  • Resting endoscopy to evaluate larynx, guttural pouches, soft palate, nasal cavity
  • Ultrasound of the larynx to assess muscle atrophy or scarring
  • CT of the head in complex cases
  • X-ray and sinus endoscopy if needed
  • Laboratory tests for infections or secretions

Treatment

Depending on the diagnosis, surgical treatment may target one or more of the following areas:

  1. Nostrils and Nasal Passages
    • Stabilization of nasal alar collapse
    • Surgical removal of atheromas
  2. Nasal Cavity & Sinuses
    • Endoscopic or surgical removal of polyps, cysts, tumors
    • Sinusotomy for chronic sinusitis or dental root infections
  3. Soft Palate & Pharynx
    • Correction of DDSP (e.g. tie-forward procedure)
    • Surgical support in cases of pharyngeal collapse
  4. Guttural Pouches
    • Laser or endoscopic treatment of mycosis
    • Lavage and drainage in case of empyema
    • Surgery for THO or muscle rupture
  5. Larynx
    • Treatment of laryngeal paralysis via laryngoplasty or nerve grafting
    • For more: see Laryngeal Surgery

Prognosis

The prognosis varies depending on the condition and the timing of intervention. Many surgical procedures, especially minimally invasive ones, result in a full return to athletic performance. Chronic or advanced conditions (e.g. tumors, permanent collapse) may limit the outcome. Early diagnosis is key to success.

Frequently Asked Questions (FAQ)

Does every breathing noise mean my horse needs surgery?

No. Many causes of breathing noise can be treated conservatively or may not affect performance. Surgery is only recommended after a full workup and in clearly diagnosed cases.

Can my horse be operated on while standing?

Yes. Many procedures—such as sinus surgeries or guttural pouch treatment—can be performed under standing sedation using minimally invasive techniques. General anesthesia is reserved for complex cases.

What’s the recovery time?

Recovery depends on the type of surgery and ranges from 1 to 8 weeks. Our team ensures individual follow-up and communication with owners throughout the healing process.

Upper airway disorders are a common cause of reduced performance in horses. Audible breathing noises—especially during exercise—are often the first sign of an anatomical or functional issue affecting structures from the nostrils to the guttural pouches. Surgical treatment is only considered after thorough diagnostics and when conservative measures have been exhausted.

At Hanseklinik, we follow a comprehensive approach combining advanced imaging, functional diagnostics, and years of surgical experience. Many procedures can be performed minimally invasively while the horse remains standing and sedated.

Häufig gestellte Fragen

Does every breathing noise mean my horse needs surgery?

No. Many causes of breathing noise can be treated conservatively or may not affect performance. Surgery is only recommended after a full workup and in clearly diagnosed cases.

Can my horse be operated on while standing?

Yes. Many procedures—such as sinus surgeries or guttural pouch treatment—can be performed under standing sedation using minimally invasive techniques. General anesthesia is reserved for complex cases.

What’s the recovery time?

Recovery depends on the type of surgery and ranges from 1 to 8 weeks. Our team ensures individual follow-up and communication with owners throughout the healing process.

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbaren Sie einen Besuchstermin im Voraus. Planen Sie etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Please schedule your visit in advance. Allow approximately 1 hour, and kindly only touch your own horse.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service
Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Appointment Image

Make an Appointment

We kindly ask you to schedule appointments by phone. This way, we can plan the best treatment for your horse individually and directly.

+49 4282 - 5946 340
Opening Hours

Please note our separate visiting hours.

Monday – Friday
8:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Besuchszeiten

Bitte vereinbare einen Besuchstermin im Voraus. Plane  etwa 1 Stunde ein und berühre bitte nur dein eigenes Pferd.

Monday – Friday
10:00 – 18:00
Saturday
9:00 – 12:00
Sunday & Public Holidays
Closed
Emergency Service – Open 24/7

Our clinic is available around the clock for emergencies.In case of an emergency, please call us immediately.

Call us:
+49 4282 - 5946 340
Appointment Image