Topic:Laryngeal Dysfunction
Laryngeal dysfunction in horses refers to a range of conditions affecting the larynx, which is a critical structure involved in breathing and vocalization. These conditions can impact the horse's performance and respiratory efficiency. Common types of laryngeal dysfunction include recurrent laryngeal neuropathy (RLN), arytenoid chondritis, and laryngeal hemiplegia. These disorders may result in abnormal respiratory noises and exercise intolerance. Diagnosis typically involves endoscopic examination to assess the structure and function of the larynx. This page compiles peer-reviewed research studies and scholarly articles that explore the etiology, diagnosis, and management of laryngeal dysfunction in horses.
Immunohistochemical analysis of laryngeal muscle of horses clinically affected with recurrent laryngeal neuropathy. As myosin heavy chain (MyHC) profile of muscle fibres is heavily influenced by neural input, changes in MyHC expression are expected in horses clinically affected with recurrent laryngeal neuropathy (RLN) yet, this has not been thoroughly investigated. Objective: To describe the changes in MyHC and fibre diameter in left cricoarytenoideus dorsalis (L-CAD) muscle of horses with clinical signs of RLN. Methods: Observational cohort study. Methods: Immunohistochemistry was used to assess the MyHC-based fibre-type proportion, size and grouping in the L-CAD of 10 Thoroughbred horses, five clinically...
An Exploratory Study into the Implantation of Arytenoid Cartilage Scaffold in the Horse. Respiratory function in the horse can be severely compromised by arytenoid chondritis, or arytenoid chondropathy, a pathologic condition leading to deformity and dysfunction of the affected cartilage. Current treatment in cases unresponsive to medical management is removal of the cartilage, which can improve the airway obstruction, but predisposes the patient to other complications like tracheal penetration of oropharyngeal content and dynamic collapse of the now unsupported soft tissue lateral to the cartilage. A tissue engineering approach to reconstructing the arytenoid cartilage would repr...
Ex vivo modeling of the airflow dynamics and two-and three-dimensional biomechanical effects of suture placements for prosthetic laryngoplasty in horses. To identify the degree of left arytenoid cartilage (LAC) abduction that allows laryngeal airflow similar to that in galloping horses, assess 2-D and 3-D biomechanical effects of prosthetic laryngoplasty on LAC movement and airflow, and determine the influence of suture position through the muscular process of the arytenoid cartilage (MPA) on these variables. Methods: 7 equine cadaver larynges. Methods: With the right arytenoid cartilage maximally abducted and inspiratory airflow simulated by vacuum, laryngeal airflow and translaryngeal pressure and impedance were measured at 12 incremental LAC...
A bitless bridle does not limit or prevent dynamic laryngeal collapse. Bits have often been incriminated as a cause of upper respiratory tract obstruction in horses; however, no scientific studies are available to confirm or refute these allegations. Clinical signs of dynamic laryngeal collapse associated with poll flexion (DLC) are induced when susceptible horses are ridden or driven into the bit. Objective: To determine whether use of Dr Cook's™ Bitless Bridle, instead of a conventional snaffle bit bridle, would reduce the severity of DLC in affected horses measured objectively using inspiratory tracheal pressures. Methods: Intervention study using each horse...
Acute Life-threatening Laryngeal Dysfunction in a Draft Horse Recovering from General Anesthesia: A Case Report. A 13-year-old Shire horse was anesthetized for an elective orthopedic procedure. During recovery from anesthesia, the occurrence of severe acute dyspnea required a second anesthetic to allow endoscopy-guided nasotracheal intubation. Endoscopic findings were decreased mobility and swelling of the arytenoids with narrowing of the laryngeal aditus. Owing to a dislodgement of the nasotracheal tube during recovery, a third anesthetic was carried out to perform emergency tracheostomy. Recovery from the third anesthetic was long and the horse developed a post-anesthetic myopathy. The clinical conditi...
Endoscopic recurrent laryngeal neuropathy grade prevalence in a sample of thoroughbred yearlings at public auction in South Africa (2013-2019). Endoscopy of thoroughbred (TB) yearlings at public auctions is common in South Africa. Laryngeal function (LF) is a common concern of buyers of young TBs. Cancellation of sale because of LF abnormalities is a concern for both the vendor and the buyer, with recurrent laryngeal neuropathy (RLN) being a common cause of sale cancellation. The aim of this descriptive study was to determine the prevalence of RLN at South African premier TB yearling sales. This study was designed as a retrospective descriptive analysis of upper respiratory tract (URT) endoscopic examinations to determine RLN grade, p...
Ex-vivo Mechanical Testing of Novel Laryngeal Clamps Used for Laryngeal Advancement Constructs. Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forwar...
External transcutaneous ultrasound technique in the equine cricoarytenoideus dorsalis muscle: Assessment of muscle size and echogenicity with resting endoscopy. Recent studies have assessed the cricoarytenoideus dorsalis muscle (CAD) using transoesophageal ultrasonography in equine recurrent laryngeal neuropathy (RLN). We assessed the CAD using the external transcutaneous ultrasound technique, which may constitute an easier method in horses. Objective: To evaluate ultrasonographic imaging of the left cricoarytenoideus dorsalis muscle (LCAD) and right cricoarytenoideus dorsalis muscle (RCAD) as a diagnostic tool for RLN using the transcutaneous ultrasound technique. Methods: Cross-sectional study. Methods: The axial plane thickness, cross-sectional are...
Evaluation of Dynamic Structural Disorders in the Upper Airways and Applied Rein Tension in Healthy Dressage Horses During Riding in Different Gaits and Head-Neck Positions. Flexion of the horse's head and neck during dressage riding reduces the pharyngeal lumen with the risk of increased upper airway resistance and upper airway obstructions. According to the Fédération Equestre Internationale, hyperflexion is achieved through force, whereas the position low-deep-round is nonforced. The objectives of this study were to evaluate (1) applied rein tension and (2) dynamic structural disorders in the upper airways in dressage horses in different gaits and different head-neck positions (HNPs). Overground endoscopy (OGE) and rein tension were evaluated in 13 clinically...
Ex vivo evaluation of arytenoid corniculectomy, compared with three other airway interventions, performed on cadaveric equine larynges with simulated recurrent laryngeal neuropathy. To compare laryngeal impedance, in terms of air flow and pressure, following arytenoid corniculectomy (COR) versus 3 other airway interventions (left-sided laryngoplasty with ipsilateral ventriculocordectomy [LLP], LLP combined with COR [LLPCOR], and partial arytenoidectomy [PA]) performed on cadaveric equine larynges with simulated left recurrent laryngeal neuropathy (RLN) and to determine whether relative laryngeal collapse correlated with the interventions performed. Methods: 28 cadaveric equine larynges. Methods: Each larynx in states of simulated left RLN alone and with airway interventio...
Dynamic laryngeal collapse associated with poll flexion as a complication of laryngeal tie-forward surgery in three harness racehorses. To report dynamic laryngeal collapse (DLC) associated with poll flexion as a potential complication of the laryngeal tie-forward procedure (LTFP) in harness racehorses. Methods: Short case series. Methods: Three harness racehorses. Methods: Preoperative and postoperative medical records of all harness racehorses that underwent the LTFP were reviewed, as were high-speed treadmill videoendoscopy recordings of 35 horses that returned for upper airway evaluation postoperatively. Results: One standardbred and two Norwegian coldblooded trotters in which dorsal displacement of the soft palate had bee...
Exercise Induced Laryngeal Obstruction in Humans and Equines. A Comparative Review. Dynamic obstructions of the larynx are a set of disorders that occur during exercise in equines and humans. There are a number of similarities in presentation, diagnosis, pathophysiology and treatment. Both equines and humans present with exercise intolerance secondary to dyspnea. During laryngoscopy at rest, the larynx appears to function normally. Abnormalities are only revealed during laryngoscopy at exercise, seemingly triggered by increased ventilatory demands, and quickly resolve after cessation of exercise. Lower airway disease (asthma being the most prevalent condition), cardiac diseas...
Investigation into pathophysiology of naturally occurring palatal instability and intermittent dorsal displacement of the soft palate (DDSP) in racehorses: Thyro-hyoid muscles fatigue during exercise. Exercise induced intermittent dorsal displacement of the soft palate (DDSP) is a common cause of airway obstruction and poor performance in racehorses. The definite etiology is still unclear, but through an experimental model, a role in the development of this condition was identified in the dysfunction of the thyro-hyoid muscles. The present study aimed to elucidate the nature of this dysfunction by investigating the spontaneous response to exercise of the thyro-hyoid muscles in racehorses with naturally occurring DDSP. Intramuscular electrodes were implanted in the thyro-hyoid muscles of nin...
Assessing pathological changes within the nucleus ambiguus of horses with recurrent laryngeal neuropathy: An extreme, length-dependent axonopathy. Equine recurrent laryngeal neuropathy (RLN) is a naturally occurring model of length-dependent axonopathy characterized by asymmetrical degeneration of recurrent laryngeal nerve axons (RLn). Distal RLn degeneration is marked, but it is unclear whether degeneration extends to include cell bodies (consistent with a neuronopathy). With examiners blinded to RLN severity, brainstem location, and side, we examined correlations between RLN severity (assessed using left distal RLn myelinated axon count) and histopathological features (including chromatolysis and glial responses) in the nucleus ambiguu...
Exploring the genetics underpinning dynamic laryngeal collapse associated with poll flexion in Norwegian-Swedish Coldblooded Trotter racehorses. Dynamic laryngeal collapse (DLC) associated with poll flexion is the most common disorder of the upper respiratory tract (URT) in the Norwegian-Swedish Coldblooded Trotter (NSCT). The disorder, which has also been diagnosed in other breeds of trotters and gaited horses, appears to be related to anatomic phenotypes and only occurs during poll flexion when the horse is exercised 'on the bit'. Objective: Identify genomic regions associated with DLC in the NSCT by combining a rigorous phenotyping protocol with genomic data from a high-density equine genotyping array. Methods: Prospective case/cont...
Racing performance of National Hunt thoroughbred racehorses after treatment of palatal dysfunction with a laryngeal tie-forward procedure and thermocautery of the soft palate with or without aryepiglottic folds resection. To assess racing performance of National Hunt thoroughbred (NH) racehorses with a definite diagnosis of palatal dysfunction treated with a laryngeal tie-forward procedure (LTF) and soft palate cautery (SPC) with or without transendoscopic laser excision of the aryepiglottic folds (TLEAF) and to determine correlation between performance measures. Methods: Retrospective cohort study. Methods: National Hunt racehorses treated with LTF, SPC ± TLEAF (n = 44) and nonaffected controls (n = 88). Methods: Performance was evaluated by using Racing Post ratings (RPR), race earnings (RE), and perform...
Abnormalities detected at pre-purchase examination of National Hunt racehorses presented at sale. Few studies are available concerning prevalences of abnormalities in the Thoroughbred horse population. Objective: Determine the prevalence of commonly observed abnormalities in a National Hunt Thoroughbred population using results of pre-purchase examinations conducted at Thoroughbred sales venues. Methods: Retrospective cross-sectional study. Methods: Veterinary pre-purchase examination certificates for 13,603 3- and 4-year-old Thoroughbred National Hunt horses from Tattersalls Ireland, Goffs Ireland and Doncaster Bloodstock Sales Ltd. (DBS) Sales were analysed. All conditions noted by the v...
Ultrasonographic findings post laryngoplasty in the horse. Laryngoplasty is commonly used to treat laryngeal hemiplegia in Thoroughbred racehorses. Evaluation of the success of the laryngoplasty is traditionally determined using endoscopy. Laryngeal ultrasonography and normal ultrasonographic appearance have been reported in the standing horse, but post-laryngoplasty and ventriculectomy ultrasonographic evaluation has limited literature coverage. A prospective case series of 10 Thoroughbred racehorses with left laryngeal hemiplegia was examined ultrasonographically and endoscopically prior to 3-10 days, 30-50 days, and 6-12 months after laryngoplasty ...
Race-day performance of horses with epiglottic entrapment, and following surgical correction using intra-oral curved bistoury hook in anaesthetised horses. Epiglottic entrapment is a condition in racing horses, associated with abnormal respiratory noises and exercise intolerance. Epiglottic entrapment has been linked to both poor and superior athletic performance, leading to concerns regarding whether surgery is indicated, and whether surgical correction may have a deleterious effect on future race performance. The objective of the current study was to assess the race-day performance of horses racing with epiglottic entrapment and the effect of surgical correction on performance outcomes using an intra-oral technique in anaesthetised horses. A ca...
Alar fold resection in 25 horses: Clinical findings and effect on racing performance and airway mechanics (1998-2013). To report clinical findings and performance in horses in which alar fold collapse (AFC) had been diagnosed and surgically treated and to assess form and degree of respiratory obstruction. Methods: Retrospective case series. Methods: Twenty-one standardbreds, 2 coldblooded trotter racehorses, 1 thoroughbred, and 1 Icelandic horse. Methods: Alar fold collapse was diagnosed on the basis of continuous abnormal expiratory flutter noise coinciding with filling of the false nostrils during exercise on a high-speed treadmill that was alleviated by suturing the alar folds (AF) temporarily in a dorsal p...
Partial arytenoidectomy in 14 standing horses (2013-2017). To report our experience with partial arytenoidectomy in sedated standing horses. Methods: Retrospective study. Methods: Fourteen client-owned adult horses. Methods: The medical records (2013-2017) of horses treated with unilateral partial arytenoidectomy while standing and sedated were reviewed. Demographics, endoscopic findings, previous treatments, and outcome after surgery were investigated and recorded. Results: Thirteen horses had unilateral left-sided recurrent laryngeal neuropathy (RLN) and 1 horse had bilateral RLN. Five horses had a previous failed prosthetic laryngoplasty. Left-side...
Asymmetric recurrent laryngeal nerve conduction velocities and dorsal cricoarytenoid muscle electromyographic characteristics in clinically normal horses. The dorsal cricoarytenoid (DCA) muscles, are a fundamental component of the athletic horse's respiratory system: as the sole abductors of the airways, they maintain the size of the rima glottis which is essential for enabling maximal air intake during intense exercise. Dysfunction of the DCA muscle leads to arytenoid collapse during exercise, resulting in poor performance. An electrodiagnostic study including electromyography of the dorsal cricoarytenoid muscles and conduction velocity testing of the innervating recurrent laryngeal nerves (RLn) was conducted in horses with normal laryngeal fu...
A retrospective cohort study of racing performance in Quarter Horses undergoing prosthetic laryngoplasty for treatment of recurrent laryngeal neuropathy. OBJECTIVE To determine effects of prosthetic laryngoplasty on return to racing, performance index, and career longevity in racing Quarter Horses with recurrent laryngeal neuropathy (RLN) and to evaluate performance variables for horses with RLN undergoing prosthetic laryngoplasty, compared with a control horse population. DESIGN Multicenter, retrospective cohort study. ANIMALS 162 racing Quarter Horses with RLN treated with prosthetic laryngoplasty (case horses) and 324 racing Quarter Horse without RLN (control horses). PROCEDURES Medical and race records of case and control horses examined at...
Outcomes of horses treated with removal of a laryngoplasty prosthesis. To determine the proportion of horses treated by laryngoplasty prosthesis removal (LPR) for complications associated with prosthetic laryngoplasty (LP), the reason for LPR, and the outcome of horses undergoing LPR to manage iatrogenic coughing/dysphagia. Methods: Retrospective study. Methods: Client-owned horses treated with LP (n = 1202) and LPR (n = 58). Methods: Clinical case records were reviewed to determine the number of horses treated with LP and LPR by the same surgeon. Historical, clinical, endoscopic, and surgical data were extracted for those horses undergoing LPR. Long-term...
Exercising upper respiratory videoendoscopic findings of 50 competition draught horses with abnormal respiratory noise and/or poor performance. Upper respiratory tract (URT) endoscopy at rest is commonly used to evaluate competition draught horses with URT conditions. Overground endoscopy might be preferred for draught horse URT evaluation as it allows the horses to be driven with harness, overcheck and cart-load under similar conditions to those experienced in the show ring where airway conditions are most prominent. Objective: To describe the exercising URT findings of competition draught horses with abnormal respiratory noise and/or poor performance. Methods: Case series. Methods: Medical records of competition draught horses under...
Evaluation of videoendoscopic examinations of arytenoid function in the 2-year-old Thoroughbred: Can we all agree? Upper respiratory tract (URT) endoscopic examination is a routine part of prepurchase examinations. Discrepancies have been documented in the assessment of arytenoid function grades (AFG) between veterinarians. Objective: To document intra- and interobserver agreement for a population of multi-experience level veterinarians for assessment of AFG of 2-year-old Thoroughbreds. Methods: Observational cohort study. Methods: One-hundred and fourteen URT videoendoscopic examinations were evaluated by 10 veterinarians. Veterinarians were categorised based on experience, into five groups, each group wi...
Identification of loci affecting sexually dimorphic patterns for height and recurrent laryngeal neuropathy risk in American Belgian Draft Horses. Equine recurrent laryngeal neuropathy (RLN) is a bilateral mononeuropathy with an unknown etiology. In Thoroughbreds (TB), we previously demonstrated that the haplotype association for height (LCORL/NCAPG locus on ECA3, which affects body size) and RLN was coincident. In the present study, we performed a genome-wide association scan (GWAS) for RLN in 458 American Belgian Draft Horses, a breed fixed for the LCORL/NCAPG risk alelle. In this breed, RLN risk is associated with sexually dimorphic differences in height, and we identified a novel locus contributing to height in a sex-specific manner:...
Nerve Stimulator-guided Injection of Autologous Stem Cells Near the Equine Left Recurrent Laryngeal Nerve. Recurrent laryngeal neuropathy (RLN) commonly affects horses and is characterized by abnormal respiratory sounds and exercise intolerance. The recurrent laryngeal nerve shows lesions of demyelination. The benefit of applying stem cells to demyelinated nerves has been demonstrated in various animal models. The aim of the study was to test the feasibility and safety of a peri-neuronal injection of autologous muscle-derived mesenchymal stem cells to the left recurrent laryngeal nerve in healthy horses by using an electrical nerve stimulator. Muscle-derived stems cell are obtained from five health...
Impact of pharyngeal endoscopic tip placement and water flushing interval on upper respiratory tract disorders in horses undergoing overground endoscopy. Endoscopic tip placement in the pharynx and water flushing interval (FI) may affect exercising upper respiratory tract (URT) endoscopic results. Objective: To determine associations between the endoscopic tip position in the pharynx and automated FI with overground endoscopic (OGE) results. Methods: Randomised balanced 2X5 factorial design. Methods: A total of n = 200 horses undergoing OGE were randomly assigned into 10 groups (n = 20/group) of different automated endoscopic FIs (no flushing, 60, 120, 180, 240 s) with the endoscope tip positioned either rostrally (position A) or caudally ...
Exploratory factor analysis of signalment and conformational measurements in Thoroughbred horses with and without recurrent laryngeal neuropathy. Conflicting results have been reported for risk factors for recurrent laryngeal neuropathy (RLN) based on resting endoscopic evaluation and comparison of single conformation traits, with many traits correlated to one another. Objective: To simplify identification of signalment and conformation traits (i.e. variables) associated with RLN cases and controls diagnosed with exercising overground endoscopy (OGE) using exploratory factor analysis (EFA). Methods: Prospective cohort. Methods: Pearson's rank correlation was used to establish significance and association between variables collected from...