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.
Ultrasound-guided biopsy of the cricoarytenoideus lateralis muscle: technique and safety in horses. Current diagnosis of recurrent laryngeal neuropathy (RLN) depends upon disease recognition in the clinically affected horse. Biopsy of the intrinsic laryngeal muscles may provide a method to identify the changes in fibre-type composition that occur in RLN before clinical signs become apparent. Objective: To develop an ultrasound-guided biopsy technique of the left cricoarytenoideus lateralis muscle (CALM) and evaluate its efficacy and safety in vivo. Methods: A longitudinal descriptive study. Methods: Six standing horses underwent ultrasound-guided biopsy of the left CALM. Frozen muscle cores ...
Results of upper airway radiography and ultrasonography predict dynamic laryngeal collapse in affected horses. The pathogenesis of dynamic bilateral laryngeal collapse (DLC) associated with poll flexion is unknown. Diagnosis is dependent upon exercise endoscopy while replicating the flexed head position harness racehorses experience during racing. Objective: To describe the effects of poll flexion on rostrocaudal laryngeal positioning and laryngeal lumen width in resting horses diagnosed with DLC compared to controls, and to establish diagnostic criteria for DLC by use of diagnostic imaging. Methods: Case-control study. Methods: Fifty harness racehorses were prospectively included in the study: 25 case...
Dynamic ventrorostral displacement of the dorsal laryngeal mucosa in horses. The objectives of this report were to describe the occurrence and features of dynamic ventrorostral displacement of the dorsal laryngeal mucosa (VRDDLM) in a group of Thoroughbred horses presented for investigation of poor performance and/or abnormal respiratory noise. Records from 600, dynamic, endoscopic examinations of the upper respiratory tract of horses were reviewed. Horses with VRDDLM were identified as those in which the dorsal laryngeal mucosa progressively obscured the interarytenoid notch and dorsoaxial portion of the corniculate processes of the arytenoid cartilages during high-sp...
Comparison of dynamic and resting endoscopy of the upper portion of the respiratory tract in 57 Thoroughbred yearlings. Endoscopic examination of Thoroughbred (TB) yearlings is performed routinely to determine the suitability of horses for racing and to ensure that the conditions of sale are satisfied. However, previous research has demonstrated that resting endoscopic examination can be inaccurate in the diagnosis of functional pathology of the upper portion of the respiratory tract (URT). Objective: To investigate the feasibility of performing dynamic overground endoscopy in a group of TB yearlings and to compare the results of resting and dynamic endoscopic examination of the URT. Methods: Prospective cohort...
Retrospective study investigating causes of abnormal respiratory noise in horses following prosthetic laryngoplasty. To investigate causes of respiratory noises in horses following prosthetic laryngoplasty (with or without a ventriculocordectomy) and to examine potential associations between degree of arytenoid abduction and the presence of other upper respiratory tract (URT) abnormalities, including right-sided collapse. Methods: Clinical records and dynamic videoendoscopic recordings were examined from horses presented between 1995 and 2010 for investigation of respiratory noise during exercise, following a prosthetic laryngoplasty (+/- a ventriculocordectomy). Relationships between the degree of left aryt...
Long-term maintenance of arytenoid cartilage abduction and stability during exercise after laryngoplasty in 33 horses. To (1) assess long-term maintenance of arytenoid cartilage abduction (ACA) after laryngoplasty (LP); and (2) correlate the residual grade of ACA and postoperative abductory loss with arytenoid cartilage stability (ACS) during exercise. Methods: Case series. Methods: Horses re-examined after laryngoplasty (n = 33). Methods: Of 89 LP horses (2005-2010), 33 had historic ACA data available and upper airway endoscopy at rest and during over-ground exercise (mean, 33 months; range, 4-71 months) after surgery. ACA grade at 1 and 6 weeks postoperatively were correlated to long-term ACA grade. Effects ...
Anatomic and neuromuscular characterisation of the equine cricothyroid muscle. As part of investigation into laryngeal stability and reanimation using functional electrical stimulation, the cricothyroid muscle might be utilised to increase laryngeal cross-sectional area in horses with recurrent laryngeal neuropathy. For optimal electrode placement and muscle recruitment, the neuroanatomy and excitability of the equine cricothyroid muscle needs to be defined. Objective: To describe the anatomy, innervation and function of the equine cricothyroid muscle and its contribution to laryngeal diameter. Methods: Seventeen equine larynges were collected at necropsy and 12 were gro...
In vitro mechanical testing of an alternate laryngoplasty system (ALPS) for horses. Mechanical evaluation of a novel alternate laryngoplasty system (ALPS). Methods: Experimental. Methods: Cadaveric horse larynges (n = 10). Methods: Arytenoid and cricoid cartilages were embedded for testing. A novel laryngoplasty system consisting of a metallic anchor, 2 stands of #2 suture material, and a metallic button were evaluated. A traditional laryngoplasty using a single strand of #5 Ethibond was evaluated in parallel. Constructs were evaluated in cyclic testing oscillating from 30 to 50 N for 3600 cycles. Constructs subsequently underwent a single cycle to failure. Distraction during...
Diagnostic sensitivity of subjective and quantitative laryngeal ultrasonography for recurrent laryngeal neuropathy in horses. 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...
The effect of palatal dysfunction on measures of ventilation and gas exchange in Thoroughbred racehorses during high intensity exercise. 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 ...
A modified laryngeal tie-forward procedure using metallic implants for treatment of dorsal displacement of the soft palate in horses. To describe a modified laryngeal tie-forward procedure (LTFP) using metallic implants. Methods: Retrospective case series. Methods: Twenty-seven horses (including 24 race horses) with dorsal displacement of the soft palate (DDSP) or palatal instability (PI) diagnosed using high-speed treadmill endoscopy (n = 15), history and resting examination (n = 8), or dynamic endoscopy over ground (n = 4). Methods: All horses underwent the modified LTFP. Modifications of the surgical procedure consisted in the use of 3 metallic stents called Suture Button(TM) through which the sutures are threaded and in ...
Cohort study examining long-term respiratory health, career duration and racing performance in racehorses that undergo left-sided prosthetic laryngoplasty and ventriculocordectomy surgery for treatment of left-sided laryngeal hemiplegia. The risk of respiratory conditions, such as inflammatory airway disease (IAD) and exercise-induced pulmonary haemorrhage (EIPH), are thought to be higher in racehorses that undergo prosthetic laryngoplasty with ventriculocordectomy (PLVC) surgery to treat left-sided laryngeal hemiplegia (LLH) than in racehorses with normal laryngeal function. However, this has not been investigated formally owing to the difficulty of obtaining reliable follow-up data. Objective: To determine the incidence of respiratory conditions (IAD and EIPH), duration of racing career, number of starts and number of starts...
Using quarterly earnings to assess racing performance in 70 thoroughbreds after modified laryngoplasty for treatment of recurrent laryngeal neuropathy. To validate and then use quarterly earnings to assess racing performance of Thoroughbreds after modified laryngoplasty for treatment of recurrent laryngeal neuropathy Methods: Retrospective cohort study. Methods: Thoroughbred racehorses after modified laryngoplasty (N = 70), and untreated cohorts (N = 210). Methods: Medical (2005-2008) and race records of 70 Thoroughbred racehorses treated by modified laryngoplasty were reviewed. Postsurgery data were collated as the number of starts and the dollar race winnings for each quarter after the date of surgery. Comparisons were made to an untreated ...
Dysphagia associated with presumed pharyngeal dysfunction in 16 neonatal foals. Dysphagia due to pharyngeal dysfunction occurs in human neonates and is associated with prematurity and hypoxic episodes. This syndrome probably occurs in neonatal foals but has not been reported. Objective: The objectives of this study were to describe 1) a series of neonatal foals with dysphagia due to pharyngeal dysfunction; 2) the progression, treatment and resolution of the dysphagia; 3) the comorbidities; and 4) the prognosis for life and athleticism for affected foals. Methods: Records from 3 referral equine hospitals were reviewed from neonatal foals with dysphagia of pharyngeal origin...
Detection of copy number variants in the horse genome and examination of their association with recurrent laryngeal neuropathy. We used the data from a recently performed genome-wide association study using the Illumina Equine SNP50 beadchip for the detection of copy number variants (CNVs) and examined their association with recurrent laryngeal neuropathy (RLN), an important equine upper airway disease compromising performance. A total of 2797 CNVs were detected for 477 horses, covering 229 kb and seven SNPs on average. Overlapping CNVs were merged to define 478 CNV regions (CNVRs). CNVRs, particularly deletions, were shown to be significantly depleted in genes. Fifty-two of the 67 common CNVRs (frequency ≥ 1%) we...
Palatal sclerotherapy for the treatment of intermittent dorsal displacement of the soft palate in 51 standardbred racehorses. This retrospective study evaluated the efficacy and side effects of palatal sclerotherapy in standardbred racehorses suspected to have intermittent dorsal displacement of the soft palate (IDDSP). Fifty-one horses were treated with multiple endoscopically guided injections of 3% sodium tetradecyl sulfate in the soft palate. Two groups were identified: those that had respiratory noises during exercise (n = 27) and those that did not (n = 24). Treatment was well-tolerated. Furthermore, horses significantly reduced their racing times for the last 400 m compared with their times before treatment an...
Complex dynamic upper airway collapse: associations between abnormalities in 99 harness racehorses with one or more dynamic disorders. 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...
Relative prevalence of upper respiratory tract obstructive disorders in two breeds of harness racehorses (185 cases: 1998-2006). Two genetically and phenotypically distinct horse breeds are used for harness racing in Scandinavia: the Standardbred (SB) and Coldblooded Trotter. These racehorses have identical environmental, management and racing conditions. Therefore, this study was undertaken to identify and compare the relative prevalence of upper respiratory tract (URT) obstructive disorders in these 2 breeds. Objective: To determine whether these 2 phenotypically different breeds of harness racehorses have different predispositions for URT disorders. Methods: Retrospective study of 88 Norwegian Coldblooded Trotters (N...
Functional electrical stimulation of intrinsic laryngeal muscles under varying loads in exercising horses. Bilateral vocal fold paralysis (BVCP) is a life threatening condition and appears to be a good candidate for therapy using functional electrical stimulation (FES). Developing a working FES system has been technically difficult due to the inaccessible location and small size of the sole arytenoid abductor, the posterior cricoarytenoid (PCA) muscle. A naturally-occurring disease in horses shares many functional and etiological features with BVCP. In this study, the feasibility of FES for equine vocal fold paralysis was explored by testing arytenoid abduction evoked by electrical stimulation of t...
A systematic review of the efficacy of interventions for dynamic intermittent dorsal displacement of the soft palate. There are numerous treatments for correction of dorsal displacement of the soft palate (DDSP). However, the efficacy of these treatments is controversial and there is little consensus on how best to treat this condition. The aims of this study were to systematically review the literature and to assess the evidence on the clinical effects of interventions for dynamic intermittent DDSP. A secondary objective was to assess whether factors relating to study quality affected reported success rates. Twenty-three studies were included, covering a wide number of interventions but also differing widely...
A novel treatment for dynamic laryngeal collapse associated with poll flexion: the modified checkrein. Dynamic laryngeal collapse (DLC) associated with poll flexion is a performance limiting dynamic upper airway disorder commonly diagnosed in Coldblooded trotters. An inspiratory obstruction occurs when affected horses are driven with tension on the reins, inducing poll flexion. To date, surgical treatment and conservative management have failed to improve racing performance in affected horses. Objective: To test the efficacy of an external device, the modified checkrein, in limiting poll flexion, diminishing laryngeal collapse and improving airway mechanics when horses are driven on a treadmill...
Results of a haplotype-based GWAS for recurrent laryngeal neuropathy in the horse. Recurrent laryngeal neuropathy (RLN) is a major upper-airway disease of horses that causes abnormal respiratory noise during exercise and can impair performance. Etiopathogenesis remains unclear but genetic factors have been suspected for many decades. The objective of this study was to identify risk loci associated with RLN. To that end we genotyped 234 cases (196 Warmbloods, 20 Trotters, 14 Thoroughbreds, and 4 Draft horses), 228 breed-matched controls, and 69 parents with the Illumina Equine SNP50 BeadChip. Using these data, we quantified population structure and performed single-marker and...
Biomechanical characterisation of equine laryngeal cartilage. Upper airway obstruction is a common problem in the performance horse as the soft tissues of the larynx collapse into the airway, yet there is a paucity of information on biomechanical properties for the structural cartilage components. Objective: To measure the geometry and compressive mechanical properties of the hyaline cartilage to improve understanding of laryngeal function and morphology. Methods: A total of 11 larynges were harvested from Thoroughbred and Standardbred racehorses. During gross dissection, linear dimensions of the cricoid were obtained. From both the cricoid and arytenoid...
In vitro effect of ventriculocordectomy before laryngoplasty on abduction of the equine arytenoid cartilage. To determine whether ventriculocordectomy (VCE) performed before prosthetic laryngoplasty (PL) results in increased rima glottidis size compared with PL alone. Methods: Experimental study. Methods: Equine cadaver larynges (n=13). Methods: Right arytenoid cartilages were maximally abducted using a standard PL technique. Standard PLs were then performed on the left side and the force required to maximally abduct the left arytenoid cartilage recorded (F(max) ). Photographs were taken of the rima glottidis at zero force and at five equal levels of force up to F(max) . The force applied was release...
Association of owner-reported noise with findings during dynamic respiratory endoscopy in Thoroughbred racehorses. To determine the association between owner-reported noise and findings during dynamic respiratory endoscopy (DRE) in a large case series. Objective: The sensitivity of owner-reported noise for dynamic upper respiratory tract obstructions in horses is low, and the specificity is high. Methods: One hundred horses underwent DRE for the investigation of abnormal respiratory noise and/or poor performance. The association of abnormal noise with findings during DRE was evaluated. Results: Eighty-five horses underwent DRE for the investigation of abnormal respiratory noise. Of these, 82% were found to...
Exercising upper respiratory videoendoscopic evaluation of 100 nonracing performance horses with abnormal respiratory noise and/or poor performance. Although well documented in racehorses, there is paucity in the literature regarding the prevalence of dynamic upper airway abnormalities in nonracing performance horses. Objective: To describe upper airway function of nonracing performance horses with abnormal respiratory noise and/or poor performance via exercising upper airway videoendoscopy. Methods: Medical records of nonracing performance horses admitted for exercising evaluation with a chief complaint of abnormal respiratory noise and/or poor performance were reviewed. All horses had video recordings of resting and exercising upper airw...
Correlation of resting and exercising endoscopic findings for horses with dynamic laryngeal collapse and palatal dysfunction. To correlate resting and exercising endoscopic grades of laryngeal function in horses undergoing high-speed treadmill endoscopy (HSTE) using the Havemeyer grading system. To correlate dorsal displacement of the soft palate (DDSP) seen at rest with palatal function during exercise. Methods: Records of horses that underwent HSTE examination (1999-2009) were reviewed. Resting laryngeal function score and other abnormalities noted on resting endoscopy were recorded as were results of HSTE. Results of resting and exercising endoscopic findings were correlated. Results: 281 horses underwent HSTE. Th...
Incidence of swallowing during exercise in horses with dorsal displacement of the soft palate. The relationship between dorsal displacement of the soft palate (DDSP) and swallowing is unclear. Objective: To quantify the relationship between DDSP and swallowing in horses at exercise. Objective: The frequency of swallowing increases immediately prior to DDSP in horses at exercise. Methods: Videoendoscopic and upper airway pressure data were collated from horses with a definitive diagnosis of DDSP at exercise. Horses with no upper airway abnormalities were matched by age, breed and sex and used as controls. Sixty-nine horses were identified with a definitive diagnosis of DDSP during the st...
Equine laryngoplasty sutures undergo increased loading during coughing and swallowing. 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. ...