Diagnosis of upper respiratory tract disorders in horses using a cheap, flexible and steerable borescope

Background: Endoscopy is essential for the diagnosis of upper respiratory tract (URT) disorders in horses but equipment is expensive and therefore not always available. An industrial borescope might be a cheap alternative to visualize the URT. Objectives: To investigate the applicability of a smartphone-connected flexible and steerable borescope to perform URT endoscopy in horses. Study design: Prospective descriptive study. Methods: In horses with a clinical indication, endoscopy was first performed with a borescope (Mini Endoscope Camera 360° Steering 720P Borescope 8mm USB car Pipe inspection Camera; approximately 300 euros) and subsequently with a veterinary endoscope (TXHD136-9D, Dr. Fritz, Germany), which was used as gold standard. Typical URT structures of interest (depending on clinical signs) were digitally recorded. Recordings of both examinations were reviewed by a blinded observer. Results: One hundred horses underwent both endoscopic examinations via the right (n=100) and left (n=24) nasal passage. In 81/83 attempts, the ethmoid and sinus opening were visualized on the right side and in 22/24 attempts on the left side. Pharyngeal and laryngeal structures could always be visualized except in 6 horses where the tip of the epiglottis could not be seen due to technical failure of the steering mechanism. In 66/72 attempts, the trachea could be visualized proximally, of which 59 all the way until the carina. Borescope and endoscope grading scores for pharyngeal lymphoid hyperplasia, recurrent laryngeal neuropathy and tracheal mucus were identical in 88/100, 93/100 and 48/59 horses, respectively. The remainder differed only one (sub)grade. The borescope was replaced halfway the study as the steering mechanism started to fail after 45 to 50 examinations. Main limitations: A wide range of borescopes exist but only one type was tested. Conclusions: A flexible, steerable borescope, connected to a smartphone, provides a cheap alternative to perform URT endoscopy in horses.

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