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.
McGivney CL, Sweeney J, Gough KF, Hill EW, Katz LM.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 ...
McGivney CL, Gough KF, McGivney BA, Farries G, Hill EW, Katz LM.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...
Elliott S, Cheetham J.Resting endoscopy has commonly been used as a method to predict laryngeal function at exercise. Objective: To perform a meta-analysis to determine the sensitivity and specificity of resting laryngeal endoscopy to predict clinical recurrent laryngeal neuropathy at exercise. Methods: Meta-analysis. Methods: Manuscripts were included if data were available for both resting and exercising airway function on all or a subset of horses. Normal resting endoscopy was defined as laryngeal grades 1 or 2 on a 4-/7-point scale or 1, 2 or 3 on a 5-point scale and normal dynamic endoscopy as a dynamic laryng...
Campoy L, Morris TB, Ducharme NG, Gleed RD, Martin-Flores M.Locoregional anaesthetic techniques can facilitate certain surgeries being performed under standing procedural sedation. The second and third spinal cervical nerves (C2, C3) are part of the cervical plexus and provide sensory innervation to the peri-laryngeal structures in people; block of these nerves might permit laryngeal lateralisation surgery in horses. Objective: To describe the anatomical basis for an ultrasound-guided cervical plexus block in horses. To compare this block with conventional local anaesthetic tissue infiltration in horses undergoing standing prosthetic laryngoplasty. Met...
Draper ACE, Piercy RJ.Recurrent Laryngeal Neuropathy (RLN) is a highly prevalent and predominantly left-sided, degenerative disorder of the recurrent laryngeal nerves (RLn) of tall horses, that causes inspiratory stridor at exercise because of intrinsic laryngeal muscle paresis. The associated laryngeal dysfunction and exercise intolerance in athletic horses commonly leads to surgical intervention, retirement or euthanasia with associated financial and welfare implications. Despite speculation, there is a lack of consensus and conflicting evidence supporting the primary classification of RLN, as either a distal ("d...
Rossignol F, Brandenberger O, Perkins JD, Marie JP, Mespoulhès-Rivière C, Ducharme NG.In horses, the only established method for reinnervation of the larynx is the nerve-muscle pedicle implantation, whereas in human medicine, direct nerve implantation is a standard surgical technique for selective laryngeal reinnervation in human patients suffering from bilateral vocal fold paralysis. Objective: (1) To describe a modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses and (2) evaluate the outcomes of reinnervation using direct nerve needle-stimulation of the first cervical nerve and exercising endosco...
Parente EJ.Recurrent laryngeal neuropathy appears to be a simple problem that should have a simple solution, yet the complexity and dynamic nature of laryngeal function is underappreciated. This review highlights the challenges and accomplishments that work towards that greater understanding of what is necessary to find a successful solution.
Mespoulhès-Rivière C, Brandenberger O, Rossignol F, Robert C, Perkins JD, Marie JP, Ducharme N.OBJECTIVE To develop and assess the feasibility, repeatability, and safety of an ultrasound-guided technique to stimulate the first cervical nerve (FCN) at the level of the alar foramen of the atlas of horses. ANIMALS 4 equine cadavers and 6 clinically normal Standardbreds. PROCEDURES In each cadaver, the FCN pathway was determined by dissection, and any anastomosis between the first and second cervical nerves was identified. Subsequently, each of 6 live horses underwent a bilateral ultrasound-guided stimulation of the FCN at the alar foramen 3 times at 3-week intervals. After each procedure, ...
Troillet A, Böttcher D, Brehm W, Scharner D.To describe the presentation, presurgical diagnostic findings, treatment, and outcome of horses with histologically confirmed, unilateral thyroid neoplasia. The complications, particularly laryngeal hemiplegia, were investigated. Retrospective case series. Client-owned horses (n=14). Medical records of horses presenting with a unilateral thyroid mass due to neoplasia from 2003-2015 were reviewed. Horses must have undergone preoperative clinical evaluations that included ultrasound examination of the mass and upper airway endoscopy. Short-term follow-up at 2 weeks after surgery and owner questi...
Carmalt JL, Johanssen B, Waldner C.To compare the performance of horses with intermittent dorsal displacement of the soft palate (IDDSP) treated surgically with a control group and to determine whether there was a difference in postoperative performance between horses treated with a staphylectomy or a tie-forward procedure. Methods: A retrospective observational study. Methods: Swedish Warmblood trotting horses (Standardbreds) with endoscopically confirmed IDDSP (n=56) and control horses (n=48) with endoscopically normal upper airways tested using overground endoscopy identified from medical records. Methods: Generalized estima...
Taylor AH, Seymour CJ.Horses may become hypoxaemic during anaesthesia despite a high inspired oxygen fraction (FiO2). A lower FiO2 is used commonly in human beings to minimise atelectasis and to improve lung function, and previously has been shown to be of potential benefit in horses in experimental conditions. Other studies suggest no benefit to using a FiO2 of 0.5 during clinically relevant conditions; however, low FiO2 (0.65) is commonly used in practice and in a large number of studies. The present study was performed to compare the effect of a commonly used FiO2 of 0.65 versus 0.90 on calculated respiratory in...
Kenny M, Cercone M, Rawlinson JJ, Ducharme NG, Bookbinder L, Thompson M, Cheetham J.Early detection of recurrent laryngeal neuropathy (RLN) is of considerable interest to the equine industry. Objective: To describe two imaging modalities, transoesophageal ultrasound (TEU) and computed tomography (CT) with multiplanar reconstruction to assess laryngeal muscle geometry, and determine the relationship between cricoarytenoid dorsalis (CAD) geometry and function. Methods: Two-phase study evaluating CAD geometry in experimental horses and horses with naturally occurring RLN. Methods: Equine CAD muscle volume was determined from CT scan sets using volumetric reconstruction with Live...
Cheetham J, Perkins JD, Jarvis JC, Cercone M, Maw M, Hermanson JW, Mitchell LM, Piercy RJ, Ducharme NG.Bilateral vocal fold paralysis (BVCP) is a life-threatening condition that follows injury to the Recurrent Laryngeal nerve (RLn) and denervation of the intrinsic laryngeal musculature. Functional electrical stimulation (FES) enables restoration and control of a wide variety of motor functions impaired by lower motor neuron lesions. Here we evaluate the effects of FES on the sole arytenoid abductor, the posterior cricoarytenoid (PCA) muscle in a large animal model of RLn injury. Ten horses were instrumented with two quadripolar intramuscular electrodes in the left PCA muscle. Following a 12-wee...
Virgin JE, Holcombe SJ, Caron JP, Cheetham J, Kurtz KA, Roessner HA, Ducharme NG, Hauptman JG, Nelson NC.Pharyngeal dysphagia is a debilitating, sometimes fatal condition in horses, with multiple aetiologies. The pathophysiology is complex and not fully understood. Treatment is largely supportive. Laryngeal advancement surgery may diminish symptoms of dysphagia and improve swallowing in affected horses. Objective: 1) to induce reversible moderate and marked pharyngeal dysphagia by regional anaesthesia of branches of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves; 2) to characterise the dysphagia produced by each model; and 3) to determine whether laryngeal advancement surgery i...
Chalmers HJ, Viel L, Caswell JL, Ducharme N.To describe the ultrasonographic changes in the cricoarytenoideus dorsalis (CAD) and cricoarytenoideus lateralis (CAL) muscles of horses before and at various times during the 32 weeks after unilateral neurectomy of the right recurrent laryngeal nerve. Methods: 28 healthy Standardbreds. Methods: For each horse, the appearance of the CAD and CAL muscles on the right (neurectomized) and left (control) sides was serially monitored ultrasonographically by percutaneous (CAD and CAL) and transesophageal (CAD) approaches. The ultrasonographic images were assessed to determine the mean pixel intensity...
Rossignol F, Vitte A, Boening J, Maher M, Lechartier A, Brandenberger O, Martin-Flores M, Lang H, Walker W, Ducharme NG.To describe the clinical experience with standing laryngoplasty in a series of horses mostly nonracing. Methods: Case series. Methods: Seventy-one client-owned horses. Methods: Medical records (April 2008-February 2014) of horses treated by standing laryngoplasty for abnormal respiratory noise and or poor performance were reviewed. Horses were included if they had a diagnosis of idiopathic right or left recurrent laryngeal neuropathy confirmed by videoendoscopy. All horses underwent a unilateral laryngoplasty with a unilateral or bilateral ventriculectomy or ventriculocordectomy. Follow-up end...
Santos MP, Gutierrez-Nibeyro SD, Horn GP, Hicke JD, Stewart MC, Schaeffer DJ.To compare the mechanical properties of laryngeal tie-forward (LTF) constructs prepared with different suture materials and suture placement patterns during single load to failure testing. Methods: Larynges harvested from 50 horse cadavers and 5 intact horse cadavers. Methods: In vitro LTF constructs were created by a standard technique with polyester sutures, a standard technique with polyethylene sutures, a modified technique with metallic implants and polyester sutures, a modified technique with metallic implants and polyethylene sutures, or a modified tie-off technique with polyester sutur...
McCarrel TM, Woodie JB.Laryngeal disorders are relatively common in the horse, and thorough diagnostic evaluation is essential to make an accurate definitive diagnosis and selection of appropriate treatment. The value of exercising endoscopy must not be overlooked, and the recent development of dynamic (overground) endoscopy is providing new insights into dynamic laryngeal lesions. The focus of this article will be on recently described disorders and treatments or modifications to existing treatments. It summarizes the numerous investigations attempting to perfect the laryngoplasty procedure for treatment of larynge...
Raffetto JA, Wearn JG, Fischer AT.Recurrent laryngeal neuropathy (RLN) causes airway obstruction and adversely affects racing performance in Thoroughbred racehorses. Prosthetic laryngoplasty (PL) is the preferred treatment of RLN as it returns variables of airway mechanics to baseline. A number of materials have been evaluated as prostheses; however, the application of Lycra has not been rigorously investigated. Objective: To evaluate the efficacy of PL using a Lycra prosthesis, in combination with transendoscopic, laser-assisted ventriculocordectomy, to restore racing performance in Thoroughbred racehorses with RLN. Methods: ...
Chesen AB, Whitfield-Cargile C.This article reviews dorsal displacement of the soft palate (DDSP) and nasopharyngeal cicatrix. Palatial instability results in exercise intolerance and upper respiratory noise in performance horses. Palatial instability can progress to DDSP either permanently or only during exercise. There have been advancements related to the etiopathogensis, diagnosis, and treatment of DDSP. The laryngeal tie-forward has gained popularity and is the most widely accepted treatment option for this condition, either alone or in combination with other procedures. Nasopharyngeal cicatrix affects a small geograph...
Fjordbakk CT, Revold T, Goodwin D, Piercy RJ.The pathogenesis of bilateral dynamic laryngeal collapse associated with poll flexion (DLC) of horses is unknown but might be associated with intrinsic laryngeal muscle weakness. Objective: To investigate histopathological characteristics of the cricoarytenoideus dorsalis, the cricothyroid (CT) and the cricoarytenoideus lateralis muscles in DLC-affected horses and compare these with unaffected controls. Our hypotheses were that evidence of neurogenic atrophy of the CT or cricoarytenoideus dorsalis muscles would be found in DLC-affected horses and that observed changes would be symmetrically (l...
Leutton JL, Lumsden JM.To investigate laryngeal function in cases of recurrent laryngeal neuropathy pre- and post laryngoplasty (LP) using dynamic respiratory endoscopy (DRE). Objective: To compare the rima glottidis area during DRE pre- and post LP; document all forms of dynamic upper airway obstruction (DUAO) pre- and post LP and investigate the relationship between post operative abduction at rest and exercise. Methods: Prospective case series. Methods: Thoroughbred racehorses with pre- and post LP DRE were included. Left-to-right arytenoid cartilage angle ratios and rima glottidis area ratios were used to quanti...
Borel N, Grest P, Junge H, Wehrli Eser M.Vascular hamartomas are non-neoplastic developmental anomalies of vessels. Cases of cerebral vascular hamartomas have been previously reported in dogs and cats. A 4-week-old Freiberger foal had shown persistent problems with breathing and swallowing since birth, and bilateral laryngeal paralysis was diagnosed. The foal subsequently developed left sided facial nerve paralysis and a secondary corneal ulcer in the left eye. Necropsy revealed a pinkish mass in the obex region of the brain. The mass was further investigated by histology and immunohistochemistry. Histologically, the mass consisted o...
Fitzharris LE, Franklin SH, Allen KJ.There is very limited published information on the prevalence and significance of abnormal breathing patterns adopted during canter/gallop. Objective: The aim of this study was to report the prevalence of abnormal breathing patterns during canter/gallop and to investigate whether these may be associated with dynamic upper respiratory tract (URT) obstructions. Methods: Retrospective analysis of clinical records. Methods: Simultaneous audio and URT videoendoscopy recordings from 365 horses referred for treadmill evaluation were analysed. Results: Thirty percent of horses had an abnormal breathin...
Offord S, Tulloch LK, Franklin SH, Tremaine WH, Woodford NS, Allen KJ.The laryngeal tie-forward (LTF) procedure has been shown to move the larynx rostrally and dorsally whilst repositioning the basihyoid bone caudally and dorsally. Other studies have shown that the position of the hyoid bones influences the size of the nasopharynx. The effect of the LTF procedure on the size of the nasopharynx is unknown. It was hypothesised that the LTF procedure would result in a decrease in dorsoventral nasopharyngeal diameter. Twenty-five thoroughbred horses which underwent LTF with or without soft palate cautery (LTF±SPC) for treatment of dorsal displacement of the soft pa...
Santos MP, Gutierrez-Nibeyro SD, Horn GP, Johnson AJ, Stewart MC, Schaeffer DJ.To compare the mechanical properties of laryngeal tie-forward (LTF) surrogate constructs prepared with steel fixtures and No. 5 braided polyester or braided polyethylene by use of a standard or a modified suture placement technique. Methods: 32 LTF surrogate constructs. Methods: Surrogate constructs were prepared with steel fixtures and sutures (polyester or polyethylene) by use of a standard or modified suture placement technique. Constructs underwent single-load-to-failure testing. Maximal load at failure, elongation at failure, stiffness, and suture breakage sites were compared among constr...
Boyko AR, Brooks SA, Behan-Braman A, Castelhano M, Corey E, Oliveira KC, Swinburne JE, Todhunter RJ, Zhang Z, Ainsworth DM, Robinson NE.Equine recurrent laryngeal neuropathy (RLN) is a bilateral mononeuropathy with an unknown pathogenesis that significantly affects performance in Thoroughbreds. A genetic contribution to the pathogenesis of RLN is suggested by the higher prevalence of the condition in offspring of RLN-affected than unaffected stallions. To better understand RLN pathogenesis and its genetic basis, we performed a genome-wide association (GWAS) of 282 RLN-affected and 268 control Thoroughbreds. Results: We found a significant association of RLN with the LCORL/NCAPG locus on ECA3 previously shown to affect body siz...
Reichel M, Martinek J.Distribution of the electrical field is very important to activate muscle and nerve cells properly. One therapeutic method to treat Recurrent Laryngeal Neuropathy (RLN) in horses can be performed by Functional Electrical Stimulation (FES). Current method to optimize the stimulation effect is to use implanted quadripolar electrodes to the musculus cricoarythenoideus dorsalis (CAD) and testing electrode configuration until best possible optimum is reached. For better understanding and finding of maximum possible activation of CAD a simulation model of the actual entire setting is currently in de...
Perkins JD, Salz RO, Schumacher J, Livesey L, Piercy RJ, Barakzai SZ.The extent to which variability affects endoscopic grading of arytenoid cartilage movement is uncertain. Objective: To determine the observer and within horse variability of grading arytenoid cartilage movement in horses during resting endoscopic examination, using a 7-grade system. Methods: Endoscopic recordings of the upper respiratory tract made at rest in 270 draught horses were reviewed independently by 2 veterinarians to assess interobserver variability when scoring horses' laryngeal function with a 7-grade system. Grading was repeated by both examiners in 80 randomly selected recordings...
Collins N, Milne E, Hahn C, Dixon P.The establishment of a single validated endoscopic laryngeal grading system for assessing recurrent laryngeal neuropathy (RLN) is desirable to facilitate direct comparisons between the findings of different clinical and research groups worldwide. The objective of this study was to assess the relationship between the Havemeyer endoscopic laryngeal grading system and histopathological changes consistent with RLN in the left cricoarytenoideus dorsalis (CAD) muscle of horses of different breeds with a full range of clinical severities of RLN, i.e., from normal endoscopic laryngeal function to comp...
Brown JA, Derksen FJ, Stick JA, Hartmann WM, Robinson NE.Show and performance horse with laryngeal hemiplegia (LH) often present for excessive respiratory noise rather than significant exercise intolerance. Therefore, the goal of surgery in these horses is to reduce respiratory noise but there are no quantitative studies evaluating the effect of any upper-airway surgery in LH-affected horses. Objective: To determine whether bilateral ventriculocordectomy (VC) reduces respiratory noise in exercising horses with laryngeal hemiplegia. Methods: Six Standardbred horses with normal upper airways were used in this study. Respiratory sounds and inspiratory ...
Tessier C, Holcombe SJ, Derksen FJ, Berney C, Boruta D.Nasopharyngeal collapse has been observed in horses as a potential cause of exercise intolerance and upper respiratory noise. No treatment is currently available and affected horses are often retired from performance. Objective: To determine the effect of bilateral glossopharyngeal nerve block and stylopharyngeus muscle dysfunction on nasopharyngeal function and airway pressures in exercising horses. Methods: Endoscopic examinations were performed on horses at rest and while running on a treadmill at speeds corresponding to HRmax50, HRmax75 and HRmax, with upper airway pressures measured with ...
Strand E, Skjerve E.Many horses demonstrate dynamic collapse of more than one upper respiratory tract (URT) structure during high-speed treadmill videoendoscopy (HSTV). Objective: To report the frequency of complex dynamic URT collapse in harness racehorses and determine if an association exists between occurrence of certain disorders. Methods: Retrospective study of 99 Standardbreds and Coldblooded trotters that had one or more dynamic URT disorders identified during HSTV between 1998 and 2006. The horses underwent HSTV using a protocol that included periods of free head carriage and poll flexion until fully fat...
Lo Feudo CM, Stucchi L, Cavicchioli P, Stancari G, Conturba B, Zucca E, Ferrucci F.To evaluate the association between the severity of dynamic upper airway obstruction (DUAO) and selected fitness parameters in Standardbred racehorses measured by treadmill test. 191 Standardbred racehorses that underwent a standardized diagnostic protocol for poor performance evaluation between 2002 and 2021 at the Veterinary Teaching Hospital, University of Milan. Horses underwent a diagnostic protocol including clinical examination, lameness evaluation, laboratory analyses, ECG, resting upper airway endoscopy, metabolic incremental treadmill test, high-speed treadmill endoscopy, postexercis...
Borel N, Grest P, Junge H, Wehrli Eser M.Vascular hamartomas are non-neoplastic developmental anomalies of vessels. Cases of cerebral vascular hamartomas have been previously reported in dogs and cats. A 4-week-old Freiberger foal had shown persistent problems with breathing and swallowing since birth, and bilateral laryngeal paralysis was diagnosed. The foal subsequently developed left sided facial nerve paralysis and a secondary corneal ulcer in the left eye. Necropsy revealed a pinkish mass in the obex region of the brain. The mass was further investigated by histology and immunohistochemistry. Histologically, the mass consisted o...
Tulleners E, Stick JA, Leitch M, Trumble TN, Wilkerson JP.To determine whether epiglottic augmentation, in conjunction with more traditional surgical methods, would be useful in the treatment of dorsal displacement of the soft palate in racehorses. Methods: Retrospective study. Methods: 40 Thoroughbred and 19 Standardbred racehorses. Methods: Polytetrafluoroethylene paste was injected submucosally on the lingual epiglottic surface of each horse. In addition, sternothyrohyoideus myectomy or sternothyroideus tenectomy and staphylectomy were performed in most horses. Results: Racing performance was improved after surgery in 29 of 40 (73%) Thoroughbreds ...
McCluskie LK, Franklin SH, Lane JG, Tremaine WH, Allen KJ.To assess the effect of head position on relative position of the larynx and hyoid apparatus in horses with palatal dysfunction, and to define a standard position for radiographic assessment of laryngeal tie-forward. Methods: Prospective clinical study. Methods: Adult horses (n=9) with palatal dysfunction. Methods: Left lateral radiographs of the larynx were obtained pre and postoperatively for 3 different head positions (flexed=90 degrees ; neutral=100 degrees ; extended=115 degrees ). Distance between thyrohyoid bone and thyroid cartilage was measured. Data were analyzed to investigate diffe...
Duncan ID, Baker GJ, Heffron CJ, Griffiths IR.The larynges of 6 horses were examined endoscopically and the findings correlated with the gross and histological appearance of the intrinsic laryngeal muscles and their nerve supply. In all cases it appeared that the balance between abductor and adductor muscle groups had been lost due to preferential atrophy of individual muscles or groups of muscles. The laryngeal abnormalities recorded were asymmetry of the larynx with asynchronous left sided abduction and fluttering or trembling of the left vocal cord and arytenoid cartilage. It is suggested that these changes represent the early signs of...
Tetens J, Derksen FJ, Stick JA, Lloyd JW, Robinson NE.To evaluate the efficacy of prosthetic laryngoplasty with and without bilateral ventriculocordectomy for treatment of experimentally induced left laryngeal hemiplegia (LLH). Methods: 15 adult Standardbreds. Methods: Horses were allotted to 3 equal groups. Sham operation (group 1), prosthetic laryngoplasty (group 2), or prosthetic laryngoplasty with bilateral ventriculocordectomy (group 3) was performed after induction of LLH. Upper airway function testing was performed prior to left recurrent laryngeal neurectomy (LRLN), 14 days after LRLN, and 60 and 180 days after surgical treatment. Measure...
Dart AJ, Dowling BA, Hodgson DR, Rose RJ.To evaluate high-speed treadmill videoendoscopy as a diagnostic technique and document the abnormalities found in Australian horses referred for poor performance associated with abnormal upper respiratory tract noise but where a definitive diagnosis could not be made at rest. Methods: A retrospective clinical study using client-owned horses. Methods: The clinical records and videorecordings of all horses referred to the University of Sydney for poor performance associated with abnormal upper respiratory tract noise during a 13-month period were examined. Only horses with a normal physical exam...
Witte TH, Cheetham J, Soderholm LV, Mitchell LM, Ducharme NG.To report (1) the force required on a single laryngoplasty suture to achieve optimal abduction of the left arytenoid cartilage, (2) peak forces experienced by the suture during induced swallowing and coughing, and during 24-hour resting activity in a stall, and (3) peak forces during induced swallowing and coughing after left recurrent laryngeal nerve blockade. Methods: Experimental study. Methods: Horses (n=8). Methods: Each laryngoplasty suture was instrumented with an E-type buckle force transducer to measure the force required for optimal intraoperative left arytenoid cartilage abduction. ...
Cheetham J, Witte TH, Soderholm LV, Hermanson JW, Ducharme NG.To develop an in vitro laryngeal model to mimic airflow and pressures experienced by horses at maximal exercise with which to test laryngoplasty techniques. Methods: Randomized complete block. Methods: Cadaveric equine larynges (n=10). Methods: Equine larynges were collected at necropsy and a bilateral prosthetic laryngoplasty suture was placed with #5 Fiberwire suture to achieve bilateral maximal arytenoid abduction. Each larynx was positioned in a flow chamber and subjected to static flow and dynamic flow cycling at 2 Hz. Tracheal pressure and flow, and pressure within the flow chamber were ...
Cheetham J, Radcliffe CR, Ducharme NG, Sanders I, Mu L, Hermanson JW.Studies are required to define more accurately and completely the neuroanatomy of the equine dorsal cricoarytenoid muscle as a prerequisite for developing a neuroprosthesis for recurrent laryngeal neuropathy. Objective: To describe the anatomy, innervation, fibre types and function of the equine dorsal cricoarytenoid muscle. Methods: Thirty-one larynges were collected at necropsy from horses with no history of upper airway disease and 25 subjected to gross dissection. Thereafter, the following preparations were made on a subset of larynges: histochemical staining (n = 5), Sihler's and acetylch...
Allen K, Franklin S.The effect of palatal instability (PI) on measures of ventilation and gas exchange is not well understood. Objective: To assess to what degree different severities of naturally occurring palatal dysfunction affect ventilation and gas exchange during strenuous exercise. Methods: A retrospective study was performed using data collected from 40 Thoroughbred racehorses diagnosed with naturally occurring dynamic palatal dysfunction during high speed treadmill exercise. Upper airway videoendoscopic recordings were made concurrently with measurements of ventilation and gas exchange. Three categories ...
Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Dacre K, McCann J.There is continuing debate on the clinical benefit of laryngoplasty (LP) in the treatment of equine laryngeal paralysis. In particular, there is little information available on the clinical value of this surgery in older horses, in non-Thoroughbreds or in sports or pleasure horses; nor on the relationship between the degree of LP abduction achieved and the clinical value of LP. Objective: To evaluate the owner's assessment of the value of LP (and combined ventriculocordectomy) in an older, mixed breed and mixed workload population of horses and to also assess the relationship between the degre...
Fitzharris LE, Franklin SH, McConnell AK, Hezzell MJ, Allen KJ.Exercise-induced upper airway collapse (UAC) probably occurs when the stabilising muscles of the upper airway are unable to withstand the dramatic changes in airflow and pressure that occurs during exercise. In racehorses, the mainstay of treatment is surgical intervention. In human athletes, exercise-induced laryngeal obstruction has been treated successfully with inspiratory muscle training (IMT). The aims of this study were: (1) to assess the feasibility of IMT in racehorses; and (2) describe the exercising endoscopy findings pre- and post-IMT in racehorses diagnosed with dynamic UAC. Horse...
Harrison GD, Duncan ID, Clayton MK.The age of onset of equine recurrent laryngeal neuropathy has not been ascertained, although the clinical condition of left laryngeal hemiplegia ("roaring") has been recognized for centuries. The purpose of this study was to evaluate the laryngeal muscles of draft horse foals for the presence of fiber-type grouping, indicating denervation and reinnervation, and to determine if histological evidence of recurrent laryngeal neuropathy was present. Abductor and adductor laryngeal muscles from the left and right sides were collected immediately after euthanasia from male draft horse foals, six less...
Hawkins JF, Tulleners EP, Ross MW, Evans LH, Raker CW.The purpose of this study was to examine the influence of laryngoplasty on racing performance and to determine if any of the following variables had a significant effect on outcome: breed (Thoroughbred v Standardbred), endoscopic grade of laryngeal function, ventriculectomy versus no ventriculectomy, type of prosthetic suture used, and number of prostheses placed. Methods: Retrospective study of laryngoplasty with or without ventriculectomy for treatment of left laryngeal hemiplegia in racehorses between 1986 and 1993. Methods: 230 horses (174 Thoroughbreds, 56 Standardbreds). Methods: The med...
Dart AJ, Dowling BA, Smith CL.To report dynamic collapse of the apex of the left corniculate process under the right corniculate process into the airway at the dorsal apposition of the paired arytenoid cartilages during exercise as a cause of upper airway dysfunction in horses. Methods: Retrospective study. Methods: Fifteen horses with a history of poor performance and/or upper respiratory tract noise during exercise. Methods: Video recordings of all horses referred for upper airway evaluation using high-speed treadmill videoendoscopy (HSTV) between January 1998 and December 2003 were reviewed. Records of horses that devel...
Reardon RJ, Fraser BS, Heller J, Lischer C, Parkin T, Bladon BM.There have been no reports of the efficacy of thermocautery of the soft palate (TSP) assessed objectively as a treatment of intermittent dorsal displacement of the soft palate (DDSP). Objective: To compare: racing performance of horses that underwent thermocautery of the soft palate with matched controls; and 'Racing Post ratings' (RPR) with prize money won (RE) and a performance index (PI) for each of the horses in the study. Objective: Thermocautery of the soft palate has no beneficial effect on racing performance and the 3 measures of performance are significantly related. Methods: The incl...
Barakzai SZ, Boden LA, Dixon PM.To evaluate the effect of laryngoplasty (LP) on race performance in longer distance (National Hunt) Thoroughbred racehorses. Methods: Case-control study. Methods: National Hunt Thoroughbred racehorses (n=71) and race-matched controls (n=126). Methods: Race records for National Hunt racehorses that had LP and ventriculocordectomy were analyzed and racing performance was compared with race-matched controls. Results: Sixty-three of 71 cases were matched with controls. Postoperatively, 78% of cases raced, 47% improved their individual performance and cases were as likely to start in 1 or 3 races a...
Dyer KR, Duncan ID.The intraneural course of nerve fibres in the equine recurrent laryngeal nerve was investigated by partially ligating the nerve at a proximal site, and 3-8 weeks later, tracing the course and spatial relationships of intact and degenerating fibres along the distal stump. This nerve was chosen because of its great length, the fact that it is a nonbranching motor nerve and because of debate about the course of abductor and adductor nerve fibres in the recurrent laryngeal nerve. Six ponies were used and in each the recurrent nerve was partially ligatured about 20 cm from the larynx, using a fine ...
Chalmers HJ, Yeager AE, Cheetham J, Ducharme N.Recurrent laryngeal neuropathy (RLN) is the most common cause of laryngeal hemiplegia in horses and causes neurogenic atrophy of the intrinsic laryngeal muscles, including the cricoarytenoideus lateralis muscle. Recurrent laryngeal neuropathy results in paresis to paralysis of the vocal fold and arytenoid cartilage, which limits performance through respiratory compromise. Ultrasound has previously been reported to be a useful diagnostic technique in horses with RLN. In this report, the diagnostic sensitivity of subjective and quantitative laryngeal ultrasonography was evaluated in 154 horses p...
Fjordbakk CT, Strand E, Hanche-Olsen S.To test the hypothesis that in bilateral dynamic laryngeal collapse associated with poll flexion, vocal fold collapse (VFC) is the initial abnormal event that induces further laryngeal collapse, and that racing performance would therefore be substantially improved after bilateral ventriculocordectomy in affected individuals. Methods: Retrospective study. Methods: Twenty-six horses. Methods: Medical records (1998-2006) of harness racehorses admitted for high-speed treadmill videoendoscopy (HSTV) that had bilateral dynamic laryngeal collapse associated with poll flexion were reviewed. Race recor...
Barakzai SZ, Dixon PM.Race records were obtained for 31 thoroughbred racehorses that were treated conservatively (rest, improvement of fitness and/or use of a tongue tie) for dorsal displacement of the soft palate, and for 62 matched control horses. Their racing performance, based on prize money won, was compared for three races run before and after the disorder was diagnosed. Nineteen (61 per cent) of the conservatively treated horses had higher earnings after conservative treatment than before treatment, compared with 27 (43.5 per cent) of the controls. There was a significant (P=0.049) increase in the earnings o...
Taylor AH, Seymour CJ.Horses may become hypoxaemic during anaesthesia despite a high inspired oxygen fraction (FiO2). A lower FiO2 is used commonly in human beings to minimise atelectasis and to improve lung function, and previously has been shown to be of potential benefit in horses in experimental conditions. Other studies suggest no benefit to using a FiO2 of 0.5 during clinically relevant conditions; however, low FiO2 (0.65) is commonly used in practice and in a large number of studies. The present study was performed to compare the effect of a commonly used FiO2 of 0.65 versus 0.90 on calculated respiratory in...
Garrett KS, Woodie JB, Embertson RM.Assessment of arytenoid movement has traditionally been performed using upper airway (UA) endoscopy. However, recent work suggests that laryngeal ultrasonography may provide additional complementary information. Objective: To determine the value of laryngeal ultrasonography for the diagnosis of recurrent laryngeal neuropathy in the horse. Objective: Horses with abnormal arytenoid movement (AM) during treadmill UA endoscopy would have increased echogenicity of the left cricoarytenoideus lateralis muscle (CALM) and smaller left CALM and vocalis size while horses with normal AM during treadmill U...
