Veterinary Surgery Deep Dive: Equine Ortho & Soft Tissue — January 2026 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic and soft tissue research from the January 2026 issue (Issue 1) of Veterinary Surgery, where three innovative studies challenge long-standing approaches to some of the most difficult conditions in equine surgery. Together, they ask an important question: Can smarter surgical techniques improve outcomes while reducing patient risk? 

From salvaging severe chronic laminitis, to performing subtotal nasal septum excision under standing sedation, and investigating a novel treatment for dorsal nasopharyngeal collapse, these studies highlight how careful biomechanical thinking and minimally invasive approaches continue to reshape equine surgery.

In this episode:

✅ Hargitaiova et al. evaluated a modified high metacarpal deep digital flexor tenotomy combined with Steward Clog shoeing for horses with chronic, refractory laminitis. By transecting the deep digital flexor tendon proximal to the accessory ligament, the technique unloads the distal phalanx while preserving passive restraint of the distal interphalangeal joint. Among 15 horses and ponies (26 limbs), only one limb developed distal interphalangeal joint subluxation (4%), while long-term survival reached 43% in horses and 50% in ponies despite the severity of disease. The study demonstrates that preserving the accessory ligament, together with immediate orthotic support, can successfully realign the distal phalanx while minimizing joint instability in cases where traditional options have failed. 

✅ Brink et al. described a standing technique for subtotal nasal septum excision using sedation, regional anesthesia, and obstetrical wire transection. Among 12 horses, 11 returned to their intended athletic use, including racehorses, while surgeons reported less intraoperative hemorrhage than is typically encountered under general anesthesia. The paper emphasizes two key technical principles: meticulous ethmoidal nerve blockade to ensure patient comfort, and creating the caudal septal cut at an angle of 60 degrees or greater to prevent postoperative airway obstruction as the septal stump heals. The findings suggest that many complex sinonasal procedures may be safely performed standing, reducing anesthetic risk while maintaining excellent long-term outcomes. 

✅ Jeong et al. investigated transendoscopic laser fenestration of the dorsal pharyngeal recess as a treatment for dorsal nasopharyngeal collapse (NPC). Using an experimental model of bilateral glossopharyngeal neurectomy, the authors found that creating a permanent communication with the guttural pouches failed to improve respiratory performance. In fact, airflow diversion into the guttural pouches appeared to worsen inspiratory airflow in experimentally induced disease. Interestingly, a single horse with naturally occurring NPC demonstrated improved exercise performance following surgery, suggesting that although the technique is ineffective for severe neurogenic collapse, it may still warrant investigation in naturally occurring, less severe cases. 

Together, these studies demonstrate that innovation in equine surgery is not simply about developing new procedures—it is about understanding biomechanics, respecting anatomy, and carefully validating new techniques before they become standard practice.

🎓 Journal Articles Discussed

• Hargitaiova et al. — High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study
• Brink et al. — Standing excision of the nasal septum of 12 horses
• Jeong et al. — Laser fenestration of the dorsal pharyngeal recess does not correct experimentally induced dorsal nasopharyngeal collapse in horses

📚 From the January 2026 Issue (Issue 1) of Veterinary Surgery

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Transcript

SPEAKER_01 0:04

Hi, I'm Carl Damiani, and this is the Simene Equine Surgery Podcast, your fast, focused update on what matters most from the latest equine surgical literature. In each episode, we break down key articles from the veterinary journals and translate them into surgical insight you can use today, not someday. This episode covers the orthopedic and soft tissue section from the January 2026 issue of Veterinary Surgery, featuring three studies that explore innovative approaches to some of the most challenging orthopedic and upper airway conditions in horses. First, we'll review Hargatiova et al. who evaluate a modified high metacarpal deep digital flexor tenotomy combined with steward clog shoeing for horses with chronic refractory laminitis. The study examines whether preserving the accessory ligament while unloading the deep digital flexor tendon can improve distal phalanx realignment, maintain distal interphalangeal joint stability, and ultimately improve outcomes in horses with severe laminitis. Next, Brinketal describe a standing technique for subtotal nasal septum excision in horses affected by nasal septal disease. By performing this complex procedure understanding sedation and regional anesthesia, the authors investigate whether surgeons can safely avoid general anesthesia while achieving good long-term respiratory function and athletic outcomes. Finally, we'll examine Zhang et al, who investigate laser fenestration of the dorsal pharyngeal recess as a potential treatment for dorsal nasopharyngeal collapse. Using an experimental model, they quantify the respiratory effects of nasopharyngeal collapse and determine whether creating a permanent communication with the guttural pouches can restore airway function and improve exercise performance. Three studies. One common theme: challenging conventional approaches with innovative surgical techniques and carefully testing whether new procedures truly improve equine patient outcomes. Let's dive in.

SPEAKER_00 2:12

You're in the OR,

Hargitaiova et al. Study: Evaluating a Modified High Metacarpal Deep Digital Flexor Tenotomy and Clog Shoeing for Chronic Refractory Laminitis.

SPEAKER_00 2:13

staring down a sinking P3 bone in a case of refractory grade four laminitis. Conservative management has failed. And, you know, you can't just walk away.

SPEAKER_03 2:24

Right. You're pretty much out of the standard options at that point.

SPEAKER_00 2:27

Exactly. You have to rebuild the foundation while a thousand pounds of horse is still actively crushing it. Welcome to the deep dive. Our mission today is delivering the fast, clinically actionable surgical intelligence you can use tomorrow to tackle exactly this scenario.

SPEAKER_03 2:43

It really is the ultimate mechanical salvage situation. Today we're pulling our insights from a new retrospective study, Hargitaiova et al. 2026.

SPEAKER_00 2:51

Aaron Powell Okay, so what's the core issue they're looking at?

SPEAKER_03 2:54

Well, they're tackling a familiar problem. Basically, using a DDFT as a salvage procedure to relieve the massive tension pulling on that sinking P3. Right. The issue, of course, is

Accessory Ligament Preservation: Explaining the clinical punchline of cutting proximal to the accessory ligament (ALDDFT) to unload the tendon while retaining passive joint support.

SPEAKER_03 3:04

that traditional mid-metacarpal or uh pasttern-level transactions frequently result in DIPJ instability.

SPEAKER_00 3:10

Trevor Burrus, Jr.: Yeah, the joint just loses its support entirely. So the clinical shift in this paper is fundamentally about where you actually make that cut, right?

SPEAKER_03 3:17

Exactly. The clinical punchline here is that they demonstrate performing a high metacarpal tonotomy proximal to the accessory ligament.

SPEAKER_00 3:27

The ALDDFT.

SPEAKER_03 3:28

Right. The ALDDFT. They intentionally preserve that ligament to maintain passive joint restraint.

SPEAKER_00 3:34

Okay, so it's almost like a well, like a suspension bridge. We're cutting the main tension cable so the deck stops pulling itself apart.

SPEAKER_03 3:41

Yeah, that's a great analogy.

SPEAKER_00 3:42

But we're strategically leaving the secondary stabilizing wires intact so the whole thing doesn't just flip. Wait, though. Yeah. If we're relying on those secondary wires, won't that preserved ligament just rupture under the horse's full weight once the DDFT is cut? I mean, does it actually hold up?

SPEAKER_03 3:59

You'd definitely think it would fail, but it's all about how the altered geometry distributes the load. By cutting proximal to the ALDDFT, you're releasing the active muscular pull.

SPEAKER_00 4:09

Okay.

SPEAKER_03 4:09

But you're leaving the passive viscoelastic check mechanism intact. The ligament doesn't take the full brunt dynamically, it just acts as a static tether.

SPEAKER_00 4:18

And that tether is enough to stabilize things.

SPEAKER_03 4:20

It is, which is enough to prevent the joint from subluxating. And the data actually backs this up beautifully. Out of 15 severely affected horses and ponies, they saw only a 4% incidence of DIPJ subluxation.

SPEAKER_00 4:36

Wow, wait, 4%? So that's what is that just one joint out of 26 limbs?

SPEAKER_03 4:41

Yes, exactly one.

SPEAKER_00 4:42

That's incredibly impressive mechanical stability. What did that mean for the patient's long term, though?

SPEAKER_03 4:47

Well, 24 months, survival was 43% in horses and 50% in ponies. Keep in mind these are highly severe cases.

SPEAKER_00 4:54

Yeah, for animals that are often facing euthanasia, those are massive numbers. But the surgical release is really only half the equation here, isn't it?

SPEAKER_03 5:02

Correct. You still have to support that newly altered geometry immediately. It's a coupled mechanical solution.

SPEAKER_00 5:07

Aaron Powell Because if you let them bear weight without support, you lose all that alignment.

SPEAKER_03 5:12

Precisely. The success relied heavily on instantly applying customized steward clogs right there in the OR.

SPEAKER_00 5:18

Oh, right in the OR.

SPEAKER_03 5:19

Yeah. Using a wooden base and soft impression putty, they provide immediate orthotic offloading, basically locking in that new anatomical reality before the horse even wakes up and bears weight.

SPEAKER_00 5:31

Makes total sense. So you've restabilized the mechanics with the clogs, but I mean you're

Simini Protect Lavage Study: Addressing standard saline's 42% bacterial remainder vs. the 0% baseline achieved by a 60-second surfactant rinse at closure to protect high-stakes salvage fields.

SPEAKER_00 5:36

operating on heavily compromised, highly stressed tissue.

SPEAKER_03 5:39

Always a huge concern in salvage cases.

SPEAKER_00 5:41

Right, because if that surgical site gets infected, the structural fix doesn't matter. You're back to square one.

SPEAKER_03 5:46

Or worse, honestly. Which brings our closure protocols right under the microscope. We uh we rely heavily on standard saline irrigation.

SPEAKER_00 5:55

Which leaves a massive blind spot.

SPEAKER_03 5:57

It does. Independent head-to-head study shows saline leaves 42% of bacteria behind.

SPEAKER_00 6:02

42%. Leaving nearly half the bacteria behind in a high-stake salvage case is terrifying. So how does Seminy Protect Lavage alter that?

SPEAKER_03 6:11

It completely eliminates that 42% delta. Yes. Semony leaves 0% of bacteria behind. Right. It acts as a non-antibiotic lavage that clears out exactly what saline misses, and it actually reinforces the closure protocol in under 60 seconds.

SPEAKER_00 6:27

Oh, so it doesn't disrupt the existing workflow at all?

SPEAKER_03 6:30

Not at all.

SPEAKER_00 6:30

Okay, so for the surgeons listening, what is the actionable take-home message from today's deep dive?

SPEAKER_03 6:36

Simply put, for refractory cases, preserving the ALDDFT during a high metacarpal tenotomy and pairing that with immediate steward clog support successfully realigns the P3 while actively preventing joint subluxation.

SPEAKER_00 6:51

Fantastic. And as always, the full article link is waiting for you in the show notes. You can dig into the specifics.

SPEAKER_03 6:56

It's definitely worth reviewing the exact geometry they used.

SPEAKER_00 6:59

Absolutely. But before we leave you today, consider this. If targeted tendon release and immediate mechanical offloading can salvage such severe structural collapse, how might advanced dynamic orthotics eventually reshape our earliest interventions for endocrine associated laminitis, you know, before that structural failure even begins.

SPEAKER_03 7:18

It really makes you wonder if we can stay ahead of the mechanics entirely.

SPEAKER_00 7:21

Right. Catch the shift before the foundation ever starts to sore another relevant study.

SPEAKER_03 7:36

We're looking at

Brink et al. Study: Describing a Standing Technique for Subtotal Nasal Septum Excision under Sedation and Regional Anesthesia.

SPEAKER_03 7:37

a recent paper, Brink et al.

SPEAKER_00 7:43

Ah, yes, excising a horse's nasal septum.

SPEAKER_03 7:46

Exactly. Traditionally, this requires general anesthesia, which we all know means expensive bills, significant risks, and frankly, a notoriously bloody surgical field. So, okay, let's unpack this. Is a standing approach genuinely feasible for a busy surgeon?

SPEAKER_00 7:59

It absolutely is. I mean, the data from Brink et al. 2026 really backs it up. They ran this retrospective study on 12 horses undergoing standing nasal septum excision.

SPEAKER_03 8:09

Just 12 horses.

SPEAKER_00 8:10

Yeah, 12 cases. But the results are very revealing. The surgical team just used sedation combined with uh topical, local, and regional anesthesia.

SPEAKER_03 8:22

Aaron Powell Okay, so no general at all.

SPEAKER_00 8:24

None. And the core finding is that making the septal cuts with strategically placed obstetrical wire isn't just viable while they're standing, it's actually highly effective.

SPEAKER_03 8:34

Aaron Powell Now wait a minute. I have to push back here.

SPEAKER_00 8:36

Aaron Powell Sure, go ahead.

SPEAKER_03 8:37

Routing wires through a conscious horse's head, like I said earlier, really does sound like a high-stakes anatomical

Gravity Hemorrhage Control: How a standing posture lowers sinonasal venous pooling pressure to keep the field subjectively cleaner than standard recumbent approaches.

SPEAKER_03 8:44

tug of war. And wouldn't a standing horse bleed excessively from a major cyanonasal excision?

SPEAKER_00 8:49

That is the main concern, yeah.

SPEAKER_03 8:51

Right. I think that would just completely compromise your surgical field.

SPEAKER_00 8:53

Aaron Powell Well, you'd think so, right. But the authors actually found the exact opposite.

SPEAKER_03 8:57

Oh, yeah.

SPEAKER_00 8:58

Yeah. The intraoperative hemorrhage was subjectively less than what you typically observe when you do the exact same surgery on a recumbent horse.

SPEAKER_03 9:05

Less bleeding. How does that work mechanically?

SPEAKER_00 9:08

Think about venous pressure. When a horse is under general anesthesia and recumbent, you get increased venous pooling, right? Ah, so higher blood pressure in the head.

SPEAKER_03 9:17

Exactly. But by keeping them standing, gravity actually works in your favor. It naturally lowers that venous pressure, which keeps the surgical field surprisingly clear.

SPEAKER_00 9:28

Wow.

SPEAKER_03 9:29

Yeah, in fact, they easily control the bleeding just by packing the nasal cavity with rolled gauze.

SPEAKER_00 9:34

Okay, so gravity does the heavy lifting for hemorrhage control. That is a massive operational win for you guys.

SPEAKER_03 9:41

It's a huge win for sure.

SPEAKER_00 9:42

Getting through the surgery cleanly is great, but getting these performance animals back to work is the real test. And the data here, I mean, 11 out of 12 returning to their full intended use is incredible.

SPEAKER_03 9:54

It really is, especially considering some more severely compromised racehorses that successfully went back to the track.

SPEAKER_00 10:00

Right. But we have to address the elephant in the room. The paper notes one mortality.

SPEAKER_03 10:04

Yes, it does.

SPEAKER_00 10:05

Looking at the data, it seems this wasn't actually a failure of the standing technique itself, but um an anesthesia complication. They suspected a subrachnoid injection, right? Exactly. And what's fascinating here is how that single mortality heavily underscores the mechanics of regional anesthesia.

SPEAKER_03 10:23

How so?

SPEAKER_00 10:24

Well, an inadvertent subrachnoid injection during a maxillary nerve block led to severe central nervous system complications. It's a tragic but vital reminder about the critical importance of precision with these regional blocks.

SPEAKER_03 10:39

That makes sense.

SPEAKER_00 10:39

Furthermore, just relying on the maxillary block isn't enough.

SPEAKER_03 10:43

Aaron Powell Because if the horse startles when you make that first incision, you've got a major problem on your hands.

SPEAKER_00 10:48

Precisely. To prevent any startled or painful reactions, surgeons have to remember to meticulously block the ethmoidal nerves as well. Complete patient comfort is completely non-negotiable when they are standing.

SPEAKER_03 11:01

Right. Because any movement throws off the actual cut. Yeah. And the cut itself is where this can all go wrong long term.

SPEAKER_00 11:06

Exactly.

SPEAKER_03 11:07

Even with perfect anesthesia, if the remaining edge of that septum heals poorly and blocks the airway, you've completely failed a performance animal. So what does this all mean for the actual

Caudal Cut Sixty-Degree Angulation: Directing a dorsorostral to ventrocaudal wire trajectory via laryngotomy to angle the stump safely out of the airway space

SPEAKER_03 11:17

cut? How do they avoid postoperative airway obstruction?

SPEAKER_00 11:20

Well, that brings us to the crucial procedural nuance of the paper. As the incised edge of the septum heals, the tissue naturally thickens.

SPEAKER_03 11:28

Okay, I follow you.

SPEAKER_00 11:29

So if you cut it straight across, that thickened stump can obstruct the nasal conchae. To prevent this, the caudal cut has to be angled at 60 degrees or more.

SPEAKER_03 11:40

Ah, so that specific angle dictates the anatomy of the heel tissue?

SPEAKER_00 11:44

Yes.

SPEAKER_03 11:45

It ensures the thickened stump rests safely out of the airway, like tucked back within the nasopharynx.

SPEAKER_00 11:50

Exactly. You want it out of the way.

SPEAKER_03 11:51

But practically speaking, how on earth are surgeons achieving a precise 60-degree angle deep in the nasal cavity of a standing horse?

SPEAKER_00 12:00

Aaron Powell It requires a very specific approach. The optimal method they described is creating that caudal cut in a dorserostral to ventricodal direction.

SPEAKER_03 12:09

Say that three times SAS.

SPEAKER_00 12:11

Right. But to actually achieve that angle, they route the obstetrical wire through a laryngotomy, and then they perform the cut while the horse's head and neck are extended.

SPEAKER_03 12:20

Okay, let's synthesize this for the surgeon listening right now who might have a septum resection on their books for next week. What are the absolute non-negotiables they need to take away from this paper?

SPEAKER_00 12:29

Here is the clinical punchline for your practice. Standing nasal septum excision effectively eliminates the expense and severe risks of general anesthesia, provided you strictly adhere to two steps.

SPEAKER_03 12:40

First step.

SPEAKER_00 12:40

First, meticulously block the ethmoidal nerves to guarantee complete patient comfort.

SPEAKER_03 12:46

And the second step.

SPEAKER_00 12:47

Second, properly angle your caudal cut, ideally through a larinotomy, to guarantee long-term airway patency.

SPEAKER_03 12:54

Fantastic. Well, thank you for joining us for this deep dive. We want to leave you with a final thought to mull over before your next case.

SPEAKER_01 13:00

Definitely.

SPEAKER_03 13:01

If standing surgery is this effective and ironically cleaner for a historically bloody major procedure like a septum resection. Wait, let me rephrase that. If it's this effective, what other traditionally recumbent cyanasal procedures are we currently overcomplicating the OR?

SPEAKER_02 13:22

Now let's take a look at what the next paper shows us.

Jeong et al. (Zhong et al.) Study: Laser Fenestration of the Dorsal Pharyngeal Recess for Dorsal Nasopharyngeal Collapse (NPC).

SPEAKER_00 13:41

Right. No, it's definitely not.

SPEAKER_03 13:42

I mean, it's like trying to run a marathon while breathing through a wet paper straw that just, you know, keeps napping shut.

SPEAKER_00 13:48

That's a great way to put it. It's this dynamic self-worsening vacuum, right as their oxygen demand peaks.

SPEAKER_03 13:53

Exactly. So if you are an equine veterinary surgeon, we are extracting actionable surgical intelligence today, specifically for your clinical decision making. We're looking at Zhang et al. 2025. Trevor Burrus, Jr.

SPEAKER_00 14:06

Right. And because waiting for horses to naturally develop severe NPC mixed for a well, a really slow study, Zhang and the team had to artificially engineer the condition.

SPEAKER_03 14:15

Aaron Powell Okay, let's unpack this. How did they actually do that? I mean, did they just sever the nerve to force the collapse?

SPEAKER_00 14:20

They did, yeah. It's a rigorous study design using six adult standard breads.

SPEAKER_03 14:24

Okay.

SPEAKER_00 14:25

And for five of them, they experimentally induced um moderate to severe dorsal NPC.

SPEAKER_03 14:30

Aaron Powell through a bilateral glossopharyngeal neurectomy, right?

SPEAKER_00 14:33

Right. Exactly. By completely transecting the motor innervation to the pharyngeal roof, they created this uh standardized absolute failure of that anatomy.

SPEAKER_03 14:44

Aaron Powell And the whole

Airflow Diversion and Ballooning Failure: Why salpingopharyngostomy failed to restore experimental metrics, actively worsening peak inspiratory flow via dynamic guttural pouch ballooning dynamics.

SPEAKER_03 14:45

goal here was to test a surgical fix, a um transendoscopic laser fenestration of the dorsal pharyngeal recess.

SPEAKER_00 14:52

Right, a salping pharyngostomy.

SPEAKER_03 14:54

Yeah. So anatomically speaking, they're targeting the guttural pouches because you know opening that space should theoretically act as a pressure equalizer between the nasopharynx and the guttural pouches.

SPEAKER_00 15:05

You got it. You're trying to break that dynamic vacuum by giving the pressure somewhere else to go.

SPEAKER_03 15:10

Aaron Powell It makes total sense on paper. But if we look at the postoperative data, did the anatomical theory actually hold up in vivo?

SPEAKER_00 15:17

Well, what's fascinating here is uh it didn't.

SPEAKER_03 15:19

Wait, really? No improvement at all?

SPEAKER_00 15:21

No, the surgery fundamentally failed to improve respiratory performance in those experimentally induced horses.

SPEAKER_03 15:27

Aaron Powell If the physics makes sense theoretically, what actually failed in the anatomy? Let's look at the numbers.

SPEAKER_00 15:32

Yeah, let's look at the clinical impact. So after induction, the mean VO2 max plummeted from 204.7 down to 141.2 milliliters per kilogram per minute.

SPEAKER_03 15:42

Wow, that's a huge drop. And post-surgery?

SPEAKER_00 15:45

It stayed exactly at 141.2. It didn't budge.

SPEAKER_03 15:48

Completely flat.

SPEAKER_00 15:49

Yeah. And even worse, peak inspiratory flow actually suffered a drop post-fenestration, down to 91.0 liters per second.

SPEAKER_03 15:58

Wait, it went down.

SPEAKER_00 15:58

Yeah. Statistically significant to a p-value of 0.03.

SPEAKER_03 16:02

Okay, I have to push back on the physics of that airway then. If they made a hole specifically to equalize pressure and relieve the vacuum, why did inspiratory flow actually get worse?

SPEAKER_00 16:12

It comes down to airflow diversion. But creating that fenestration,

The Naturally Occurring Outlier: Contrasting flat experimental results against a single naturally occurring NPC case that experienced subjective performance and VO2 max increases.

SPEAKER_00 16:16

a portion of the airflow during peak inspiration was diverted directly into the guttural pouches.

SPEAKER_03 16:21

Oh, like a ballooning effect.

SPEAKER_00 16:22

Exactly. The pouches fill up with air, they push down, and that just exacerbates the collapse of the pharyngeal roof instead of relieving it.

SPEAKER_03 16:29

That ballooning effect is such a crucial mechanical detail. But here's where it gets really interesting. Looking through the data cohort, you mentioned five horses were experimentally induced. Right.

SPEAKER_00 16:39

But the study used six horses total. That sixth horse wasn't experimentally induced, right? It had naturally occurring NPC.

SPEAKER_03 16:47

Yeah, and that is the crucial nuance of this entire paper. For that single naturally occurring case, the surgery had the exact opposite effect.

SPEAKER_00 16:55

The VO2 max actually increased in it.

SPEAKER_03 16:58

It did, from 208.9 up to 221.8 post-surgery, which showed a subjective improvement.

SPEAKER_00 17:04

Why such a drastic difference? Is it just that um naturally occurring NPC doesn't mimic the blunt force trauma of a complete nerve transaction?

SPEAKER_03 17:13

That is the leading theory, yeah. A complete bilateral neurectomy creates this severe absolute flaccidity. The ballooning guttural pouches easily overpower it.

SPEAKER_00 17:22

Right, there's no resistance.

SPEAKER_03 17:23

Exactly. But in a naturally occurring case, the pathology is often milder or at least more progressive. The horse might still have some residual muscle tone.

SPEAKER_00 17:31

Which allows the pressure equalization to actually do its job without the roof entirely caving in.

SPEAKER_03 17:36

Spot on.

SPEAKER_00 17:36

So if you're an equine surgeon scrubbing in tomorrow for a horse with severe neurogenic NPC, what's the ultimate takeaway? The takeaway is that this experimental model does not support clinical application of laser cell pingophoryngostomy for severe, complete neurogenic NPC.

SPEAKER_03 17:52

So your surgical approach tomorrow doesn't change?

SPEAKER_00 17:54

Right. It doesn't. However, because of that one natural outlier, you shouldn't write the technique off completely for milder, naturally occurring cases?

SPEAKER_03 18:03

Aaron Powell A great reminder that not all pathology is created equal. You know, the mechanics of the airway are just incredibly unforgiving. Thank you for joining us on this deep dive.

SPEAKER_00 18:12

Thanks for having me.

SPEAKER_03 18:12

But as you head out to your practice today, consider this. The neurectomy created a complete irreversible nerve transection. Could the severe nature of our perfect experimental models actually be masking the potential benefits of surgeries designed for the nuanced progressive reality of natural disease?

SPEAKER_00 18:30

It's definitely something to mull over before your next case.

SPEAKER_02 18:43

Our interoperative lavage developed to target resistant bacteria and biofilms where traditional solutions of saline and post op antibiotics fall short. If you're interested in learning more or trying out your own procedures, you'll find information and links in the show notes. Thanks for listening, and we'll see you in the next episode.