Is there a place for thermocautery of the soft palate?

Quantity and quality of studies

Level of evidence Five studies were identified that investigated the effects of thermocautery of the soft palate [1–5]. The level of evidence presented by these studies ranged between levels 2–4: one study was a case series evaluating data pre- and post treatment (level 4, [1]), 3 studies were level 3–4 (parallel pre–post treatment studies [2,4,5]) and one was level 2 (cohort study using racing peers [3]).

Inclusion criteria

The largest studies ([1] n = 187 and [3] n = 110) did not include any horses with a definitive diagnosis of dorsal displacement of the soft palate (DDSP). Knowing that a presumptive diagnosis of DDSP carries with it a 35% misdiagnosis rate [6], it is likely that these 2 studies included a good number of horses that did not have the disorder. A definitive diagnosis of palatal dysfunction was obtained in all horses in 3 studies [2,4,5].

Comparator groups

Three studies used appropriate comparator groups of alternative interventions for DDSP in which all horses had been definitively diagnosed [2,4,5] and one study assessed the treatment group against a race-peer matched comparison population [3].

Variation in treatments

Three studies reported on horses which had had only thermocautery, however Franklin et al. [4] and McCluskie et al. [5] included some horses which had had sub-epiglottic resection concurrently performed. No study gave a clear indication of the technique of thermocautery employed, i.e. how many points or what % surface area of the palate was fired, for what period of time was the hot iron left in place for, etc.  […]