Technique for guttural pouch bead removal using a novel three‐dimensional ( 3D) ‐printed instrument

Abstract Objective The aim of the present study was to determine if a three‐dimensional (3D)‐printed instrument technique would improve lavage removal of plastic beads (guttural pouch [GP] chondroid mimics) through a dorsal pharyngeal recess (DPR) fenestration. We hypothesized that using a 3D‐printe...

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Bibliographic Details
Published in:Veterinary surgery 2024-07
Main Authors: Cardona, Guillermo C., Dahlgren, Linda A., Byron, Christopher R., McKenzie, Harold C., Werre, Stephen R., Bogers, Sophie H.
Format: Article
Language:English
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Summary:Abstract Objective The aim of the present study was to determine if a three‐dimensional (3D)‐printed instrument technique would improve lavage removal of plastic beads (guttural pouch [GP] chondroid mimics) through a dorsal pharyngeal recess (DPR) fenestration. We hypothesized that using a 3D‐printed instrument placed through the DPR fenestration would remove more beads, reduce lavage time and incur less soft tissue damage than using a lavage tube control or instrument placement through the salpingopharyngeal ostium (SPO). Study design Experimental cadaveric study. Sample population A total of 30 cadaveric equine heads. Methods DPR fenestration was performed using transendoscopic laser and 50 plastic 12 mm beads were placed into one GP of horse heads. Four removal procedures using a 3D‐printed instrument or lavage tube control placed through the DPR fenestration or the SPO were compared. Number of beads removed and number of 2‐min lavage cycles to recover ≥96% of beads or three consecutive no‐yield cycles were recorded. Endoscopic soft tissue damage was graded. Data were compared by generalized estimating equations (GEE) model and Fisher's exact test ( p < .05). Results More beads (median 48 beads; range 0–49) were removed faster (median 24 beads/cycle; range 12–50) using the 3D‐printed instrument compared to control (median 6 beads; range 0–29, 0.66 beads/cycle, range 0–49). There was no difference between total beads removed or removal speed between placement sites. There was no difference in soft tissue damage between procedures. Conclusion Our 3D‐printed instrument enabled efficient plastic bead removal. Clinical significance DPR fenestration and use of our 3D‐printed instrument represents an alternative to current chondroid removal techniques, warranting investigation in clinical cases.
ISSN:0161-3499
1532-950X
1532-950X
DOI:10.1111/vsu.14141