Sussex Equine Hospital provides the most advanced state-of-the-art treatment options available for horses with upper airway problems. These include tie backs and laryngeal re-innervation, both of which can be done standing without the need for horses to go through a general anaesthetic.

Performing the surgery standing offers many advantages to both the horse and the veterinary surgeon. It avoids the risks associated with general anaesthetic and recovery, and at the same time, offers improved visibility to the surgeon, which in the majority of cases aids completion.

Roaring occurs as a consequence of an unhealthy nerve not firing the muscle responsible for opening the airway. As a consequence, the amount of air flowing into the lungs is reduced during the horse’s physical activity, causing fatigue.

The tie-back surgery has long been recognised and practised as a treatment for ‘roaring’. During the tie-back, the opening into the airway is ‘tied’ open so that the flow of air into the lungs is increased. Laryngeal re-innervation is another surgical option available for some ‘roarers’. This technique effectively replaces the unhealthy nerve by a separate healthy nerve. During laryngeal re-innervation, the healthy nerve is identified and implanted into the main muscle responsible for opening the airway so that the horse has a good chance of recovering its ability to open its airway itself.

Laryngeal re-innervation was actually developed in the 1980s. However, in recent years, further developments and refinement of the technique now provides an excellent surgical option for many horses and the standing surgery is rapidly

becoming popular. Dr Fabrice Rossignol (Clinique de Grobois, France) is a world-renowned veterinary surgeon who has been a key figure in the recent development of laryngeal re-innervation on horses. The Sussex Equine Hospital is privileged to work closely with Dr Rossignol, who has provided his top-quality expertise and guidance for some of our more complicated cases.

Sussex Equine Hospital has already treated a good number of horses with standing tie-backs and nerve implantations on the standing horse with impressive results.