Single-stage wry nose repair shows promise in four foals

A newly published Equine Veterinary Journal case series is putting fresh detail behind a difficult equine surgery: single-stage correction of campylorrhinus lateralis, or wry nose, in foals. Published online July 18, 2026, the paper reports on four horses treated with transection and fixation, with the authors concluding that the approach produced satisfactory long-term functional and cosmetic outcomes despite a meaningful complication burden. (madbarn.com)

Wry nose is a rare congenital maxillofacial deformity that can distort the nasal septum, maxilla, and premaxilla, leading to airway obstruction, malocclusion, nursing difficulty, and poor long-term function in more severe cases. Clinical guidance has historically come from small reports and individual surgical descriptions, including earlier work by Schumacher and colleagues, external fixation approaches, and distraction techniques. More recent educational coverage has emphasized how the deformity can worsen as the foal grows, especially over the first several months of life, narrowing airflow and complicating feeding. (madbarn.com)

In the new series, all four foals were presented for respiratory difficulty. Preoperative workups included physical and oral examinations, radiography, and CT when available. The surgical protocol involved temporary tracheostomy and laryngotomy to secure the airway, resection of the nasal septum, osteotomy and fixation of the nasal bones with plates and screws, and transection and fixation of the premaxillae and maxillae with pins and wires. Rib grafting and alar fold resection were used selectively rather than routinely; only one horse in the series received a rib graft. At follow-up of at least 12 months, all four horses reportedly grazed and masticated normally, maintained good body condition, and had improved respiratory function. Three were able to perform their intended athletic endeavor. (madbarn.com)

The complications are at least as clinically relevant as the successes. Every horse in the series developed a plate-associated infection, and one developed an oronasal fistula. That makes this less a story about a simple fix than about a technically demanding salvage-style reconstruction that can still yield acceptable long-term results in carefully managed cases. The study’s own limits are clear: it was retrospective, included only four horses, and relied in part on owner-reported long-term outcome. (madbarn.com)

Outside the paper, recent industry and educational coverage helps explain why this matters in practice. The Horse has noted that severe wry nose cases can leave foals unable to nurse safely, at risk for aspiration pneumonia, or unable to maintain adequate airflow, while EquiManagement described how progressive facial growth can worsen deviation and trigger later respiratory compromise even in foals that initially nurse and breathe adequately. A 2023 University of Saskatchewan report on a severe filly case also highlighted the level of specialty coordination these surgeries can require, including CT planning, septal resection, fixation, and rib graft harvest, with Schumacher cited there as a go-to surgeon for the condition. (thehorse.com)

Why it matters: For equine veterinarians, the paper offers a more current procedural roadmap for a rare problem that most clinicians will see infrequently, if at all. The practical takeaway isn’t that every wry nose foal should go to surgery. It’s that referral candidates with meaningful airway compromise may have a viable one-stage option, but the path involves advanced imaging when possible, complex anesthesia and airway planning, implant management, and a realistic discussion with pet parents about infection risk, aftercare, cost, and the difference between functional improvement and anatomic normality. (madbarn.com)

The report also fits into a broader shift toward documenting long-term function, not just immediate technical success. A related 2026 Equine Veterinary Education publication from Vasco and colleagues points to growing interest in owner-perspective and long-term outcome data after wry nose surgery. That’s useful in a condition where the goals are often practical, restoring airflow, allowing normal grazing and mastication, and supporting acceptable athletic use, rather than achieving a perfect cosmetic correction. (beva.onlinelibrary.wiley.com)

What to watch: The next step is better comparative evidence, including how this one-stage approach stacks up against other fixation or distraction techniques, whether earlier intervention changes outcomes, and which complications are most predictable and preventable. For now, this paper strengthens the evidence base for referral centers managing severe wry nose, while also reminding clinicians that success may come with a high postoperative management burden. (madbarn.com)