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.
Association of treadmill upper airway endoscopic evaluation with results of ultrasonography and resting upper airway endoscopic evaluation. 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...
Three-dimensional biomechanics of simulated laryngeal abduction in horses. To investigate the influence of simulated contraction of the cricoarytenoideus dorsalis (CAD) muscle on the 3-D motion of the arytenoid cartilage. Methods: 5 larynges from equine cadavers. Methods: Serial computed tomographic scans of each larynx were conducted at 7 incremental forces simulating contraction of medial, lateral, and combined bellies of the left CAD muscle. Three-dimensional reconstruction of radiopaque markers placed at anatomic landmarks on the left arytenoid and cricoid cartilages enabled quantification of marker displacement according to a Cartesian coordinate system. Rotatio...
Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses. The success rate of prosthetic laryngoplasty is limited and may be associated with significant sequelae. Nerve muscle pedicle transplantation has been attempted but requires a year before function is restored. Objective: To determine the optimal parameters for functional electrical stimulation of the recurrent laryngeal nerve in horses. Methods: An experimental in vivo study was performed on 7 mature horses (2-21 years). A nerve cuff was placed on the distal end of the common trunk of the recurrent laryngeal nerve (RLN). In 6 horses the ipsilateral adductor branch of RLN was also transected. T...
Functional electrical stimulation of the left recurrent laryngeal nerve using a vagus nerve stimulator in a normal horse. The aim of this study was to assess the feasibility of implanting an existing vagus nerve stimulating (VNS) electrode around the recurrent laryngeal nerve. The stimulus response characteristics required to achieve abduction of the ipsilateral arytenoid by the VNS electrode in the normal horse could then be determined. The electrode was wound around the left recurrent laryngeal nerve at the cervical level and connected to a pulse generator. Stimulus response characteristics were obtained by measuring stimulated arytenoid displacement endoscopically in the standing, non-sedated horse. A full and...
Mechanical evaluation of the equine laryngoplasty. Mechanical evaluation of the equine laryngoplasty. Methods: Experimental. Methods: Cadaveric cricoid (n=36) and arytenoid (46) cartilages. Methods: Arytenoid and cricoid cartilage specimens were embedded for testing. Suture material (2 Ethilon, 5 Ethibond, or 5 Fiberwire) was inserted simulating laryngoplasty procedures. Constructs were evaluated in single or cyclic loading. Single cycle tests recorded load at failure and stiffness. Cyclical tests recorded displacement after 10,000 cycles. ANOVA and t-tests were used (significance P<.05). Results: The arytenoid Ethibond (241.10+/-47.67 N) cons...
Branchial remnant cysts of mature and juvenile horses. This clinical report describes 8 cases of branchial remnant cysts (BRC) in the horse. The horses presented with bimodal age distribution, with 5 cases in mature horses (age 8-21 years) and 3 in foals (age 1, 6 and 10 months). Mature cases presented for dysphagia or intermittent oesophageal obstruction (2/5), and retropharyngeal swelling (3/5), whereas respiratory stridor and visible mass were presenting complaints in the foals. Presence of a right-sided (5/8) or dorsally located (2/8) palpable retropharyngeal mass of 3-35 cm diameter was noted clinically; one left-sided mass was identified as ...
Induration of the cricoid cartilage complicates prosthetic laryngoplasty in a horse. To report intraoperative complications during needle penetration and suture placement through the cricoid cartilage during a prosthetic laryngoplasty procedure. Methods: Case report. Methods: An 11-year-old American Paint gelding with grade IV left laryngeal hemiplegia underwent a terminal prosthetic laryngoplasty for teaching purposes. Passage of the needle through the cricoid cartilage was difficult and resulted in needle breakage before eventual success using a new needle. The larynx was examined postmortem. Results: Palpation of the larynx revealed hardening of the cricoid cartilage. Radio...
Successful treatment of persistent dorsal displacement of the soft palate and evaluation of laryngohyoid position in 15 racehorses. Caudal descent of the larynx has been proposed to be associated with intermittent dorsal displacement of the soft palate (DDSP) as it leads to a loss of the seal between the epiglottis and soft palate but further investigation of this theory is required. Objective: To evaluate laryngohyoid position of horses with persistent DDSP in comparison to horses with intermittent DDSP and evaluate the outcome of treatment. Objective: Horses with persistent DDSP have a different laryngohyoid position compared to those with intermittent DDSP. Horses with persistent DDSP can be returned successfully to rac...
Diagnosis of laryngeal dysplasia in five horses using magnetic resonance imaging and ultrasonography. Laryngeal dysplasia due to suspected maldevelopment of the fourth branchial arch has been reported previously in the horse and has been associated with rostral displacement of the palatopharyngeal arch and/or right laryngeal dysfunction. These studies all described the endoscopic and/or anatomical post mortem identification of the disease, but ultrasonography or magnetic resonance imaging (MRI) of this disease have not been described. Objective: MRI and ultrasound findings accurately reflect the anatomical features of presumptive fourth branchial arch abnormality and allow accurate ante mortem...
Effect of ventriculectomy versus ventriculocordectomy on upper airway noise in draught horses with recurrent laryngeal neuropathy. Little is known about the efficacy of bilateral ventriculectomy (VE) or bilateral ventriculocordectomy (VCE) in draught horses. Objective: To compare the effect of VE and VCE on upper airway noise in draught horses with recurrent laryngeal neuropathy (RLN) by use of quantitative sound analysis techniques. Objective: In competitive draught horses with grade 4 RLN, VE and VCE reduce upper airway noise during exercise, but VCE is more effective. Methods: Thirty competitive hitch or pulling draught horses with grade 4 RLN were evaluated for upper airway sound during exercise. Respiratory rate (RR)...
Postoperative race performance is not correlated with degree of surgical abduction after laryngoplasty in National Hunt Thoroughbred racehorses. To (1) assess the degree of arytenoid cartilage abduction lost after laryngoplasty (LP) in Thoroughbred National Hunt racehorses and (2) to correlate postoperative racing performance with degree of arytenoid abduction after LP. Methods: Case series. Methods: National Hunt Thoroughbred racehorses (n=68). Methods: Grade of postoperative arytenoid abduction for National Hunt racehorses that had LP with ventriculocordectomy was assessed at 1 day, 6 days, and 6 weeks after LP. Race records were analyzed to ascertain if there was correlation between the degree of arytenoid cartilage abduction and va...
Race performance after laryngoplasty and ventriculocordectomy in National Hunt racehorses. 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...
Evaluation of the cranial cruciate ligament repair system(®) in surgery for laryngeal hemiplegia in heavy draft horses. The purpose of this study was to evaluate the effect of the canine cranial cruciate ligament repair system on laryngeal hemiplegia in heavy draft horses. Twenty-four heavy draft horses diagnosed with grade 4 laryngeal hemiplegia were allocated to either the prosthetic laryngoplasty (PL) group (n=14) or a canine cranial cruciate ligament repair system (CCCLRS) group (n=10). Right to left angle quotients (RLQs) of abductions of the arytenoid cartilages were endoscopically evaluated before and after surgery. Post-operative RLQs in the CCCLRS group were significantly lower than those of the PL gro...
Variability of resting endoscopic grading for assessment of recurrent laryngeal neuropathy in horses. 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...
Effect of magnitude and direction of force on laryngeal abduction: implications for the nerve-muscle pedicle graft technique. The nerve-muscle pedicle graft technique is a treatment for recurrent laryngeal neuropathy (RLN), but the optimal placement of the pedicles within the cricoarytenoideus dorsalis (CAD) muscle is unknown. Objective: The magnitude and direction of force placed on the muscular process of the left arytenoid cartilage affects the magnitude of laryngeal abduction. Methods: Five larynges were harvested from cadavers. Using increments of 0.98 N, a dead-weight force generator applied a force of 0-14.7 N for 1 min each to the left muscular process at 0, 10, 20, 30, 40, 50, 60 and 70 degrees angles. The r...
Correlation of the Havemeyer endoscopic laryngeal grading system with histopathological changes in equine Cricoarytenoideus dorsalis muscles. 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...
Immunohistochemical analysis of laryngeal muscles in normal horses and horses with subclinical recurrent laryngeal neuropathy. We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the le...
Effect of poll flexion and dynamic laryngeal collapse on tracheal pressure in Norwegian Coldblooded Trotter racehorses. Dynamic laryngeal collapse (DLC) associated with poll flexion is a newly diagnosed upper respiratory tract obstructive disorder that causes poor racing performance. Objective: To determine if Norwegian Coldblooded Trotters (NCTs) affected with DLC associated with poll flexion differ from normal, elite NCTs based on simple airway mechanics measurements. Methods: Five normal elite NCTs and 6 NCTs diagnosed previously with DLC underwent treadmill videoendoscopy while tracheal pressures were measured continuously. Alternating head positions were used such that horses were exercised with free head ...
Racing performance after combined prosthetic laryngoplasty and ipsilateral ventriculocordectomy or partial arytenoidectomy: 135 Thoroughbred racehorses competing at less than 2400 m (1997-2007). The success of combined prosthetic laryngoplasty with ipsilateral ventriculocordectomy (LPVC) has not been compared to that of partial arytenoidectomy (PA) in a clinical population. Objective: In Thoroughbred (TB) racehorses: (1) earnings after LPVC are unaffected by the severity of recurrent laryngeal neuropathy (RLN) (laryngeal grade III vs. grade IV); (2) LPVC and PA yield similar results in the treatment of grade III RLN; (3) performance outcome following PA is independent of diagnosis (RLN vs. unilateral arytenoid chondritis [UAC]); and (4) neither LPVC nor PA returns horses to the level ...
Efficacy of thermal cautery for intermittent dorsal displacement of the soft palate as compared to conservatively treated horses: results from 78 treadmill diagnosed horses. Previously, objective comparisons of surgical procedures to relieve dorsal displacement of the soft palate (DDSP) have been limited by the presumptive basis of the diagnostic measures applied. Objective: To assess and compare the efficacy of thermal cautery surgery to conservatively treated controls in racehorses definitively diagnosed with idiopathic intermittent DDSP. Objective: Both conservative and surgical treatments have a beneficial result on racing performance in racehorses affected with DDSP. Methods: Race records were obtained for Thoroughbred racehorses definitively diagnosed with D...
Bilateral laryngeal paralysis associated with hepatic dysfunction and hepatic encephalopathy in six ponies and four horses. Six ponies and four horses with a mean (sd) age of 15.9 (6.0) years developed sudden-onset bilateral laryngeal paralysis (BLP) in association with hepatic dysfunction. Nine of them had been referred for the investigation of respiratory distress, and one pony had been referred for weight loss before BLP developed. Nine of the animals had clinicopathological evidence of liver disease, and nine had histological evidence of liver disease. All of the animals had one or more of the following: hepatic encephalopathy (in eight), hyperammonaemia (in six) and endoscopic evidence of BLP (in nine). Three ...
Histological and ultrastructural evidence that recurrent laryngeal neuropathy is a bilateral mononeuropathy limited to recurrent laryngeal nerves. Recurrent laryngeal neuropathy (RLN) is a common and debilitating peripheral nerve disease of horses, but it remains unclear if this disease is a mono- or polyneuropathy. An understanding of the distribution of the neuropathological lesions in RLN affected horses is fundamental to studying the aetiology of this very significant disease of tall horses. Objective: To determine whether RLN should be classified as a mono- or polyneuropathy. Methods: Multiple long peripheral nerves and their innervated muscles were examined systematically in 3 clinically affected RLN horses Results: Severe lesions ...
In vitro model for testing novel implants for equine laryngoplasty. 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 ...
Surgical and conservative management of bilateral dynamic laryngeal collapse associated with poll flexion in harness race horses. 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...
Effect of head position on radiographic assessment of laryngeal tie-forward procedure in horses. 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...
Association of increased tracheal mucus accumulation with poor willingness to perform in show-jumpers and dressage horses. The objective of this study was to examine the association of pharyngeal lymphoid hyperplasia (PLH), recurrent laryngeal neuropathy (RLN), mucus accumulation (MA) score and tracheobronchial secretion neutrophil percentage (TBS-N) with rider-assessed performance in sport horses. Airway endoscopy scores, tracheobronchial secretion cytology, rider-assessed general impression and willingness to perform were investigated in 171 top-level sport horses. Increased MA appears to be associated with poor willingness to perform in sport horses. Older horses had decreased PLH scores and increased TBS-N. Mu...
Palatal sclerotherapy: a potentially useful treatment of intermittent dorsal displacement of the soft palate in juvenile standardbred racehorses. This study was aimed at evaluating the tolerability and the efficacy of palatal sclerotherapy in juvenile standardbred racehorses with easily audible "snoring-like" respiratory noises suspected to be the result of intermittent dorsal displacement of the soft palate. The palate of 8 horses was injected with sodium tetradecyl sulfate under videoendoscopic guidance. Palatal sclerotherapy resulted in resolution of the respiratory noise in 7 horses, improvement of performance in 6 horses, and mild side effects in only 3 horses. This preliminary study suggests that palatal sclerotherapy is a safe, r...
Racing performance following the laryngeal tie-forward procedure: a case-controlled study. The laryngeal tie-forward procedure (LTFP) is becoming widely used for correction of dorsal displacement of the soft palate (DDSP) despite the absence of an evidence-based assessment of its efficacy. Objective: The LTFP returns racing performance to preoperative baseline levels and to that of matched controls; and post operative laryngohyoid position is associated with post operative performance. Methods: Case-controlled study of racehorses undergoing a LTFP for dorsal displacement of the soft palate at Cornell University between October 2002 and June 2007. Methods: The presence of at least on...