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.
Excision of intralaryngeal granulation tissue in 25 horses using a neodymium:YAG laser (1986 to 1991). Granulation tissue masses arising from the axial surface of the arytenoid cartilage in 25 horses were excised using a contact neodymium:yttrium aluminum garnet laser. A technique that eliminated the need for general anesthesia or laryngotomy was developed for transen-doscopic removal of the masses in standing horses. Nineteen racehorses made abnormal upper respiratory tract noises or their performance was decreased, whereas six horses not used for racing had a history of stertor (five horses) or epistaxis after nasogastric intubation (one horse). Thoroughbreds were significantly (p = .0126) ov...
[Laryngeal hemiplegia in warmblood horses–a study of stallions, mares and their offspring]. Laryngoscopic examination during sedation was performed on 24 stallions and on their offspring (240 foals and 474 adult horses). Additionally the dams (n = 308) of 35 foals and 216 horses were examined. With the bilateral comparison of the arytaenoid movements the function of the abductory and adductory laryngeal muscles were evaluated and the left abductory dysfunction (idiopathic laryngeal hemiplegia, ILH) was divided into six degrees. The incidence and degree of ILH depended on age and the occurrence of the same dysfunction in the parents. Foals suffered in significantly lower number (24.7 ...
Temporary bilateral laryngeal paralysis in a horse associated with general anaesthesia and post anaesthetic myositis. An eight-year-old Highland pony which had previously shown normal laryngeal function, underwent general anaesthesia for surgical treatment of a mandibular sinus. During its recovery from the anaesthesia, the pony suffered great respiratory distress and stridor, due to total bilateral laryngeal paralysis and pulmonary oedema. The animal was immediately given a temporary tracheostomy. Some hours later, postoperative myositis developed; it resolved within two days and the pony's laryngeal function returned to normal during the following year.
Partial arytenoidectomy in the horse using an extralaryngeal approach. An extralaryngeal approach to partial arytenoidectomy in the horse was developed by in vitro experiments on isolated larynges and then on intact equine cadavers. The goals of the approach were to preserve the laryngeal mucosa, eliminate the need for a laryngotomy or tracheotomy, and minimize postoperative complications. The new approach was evaluated in seven horses with normal upper respiratory tracts. Left laryngeal hemiplegia was surgically created, and, after a 30-day convalescence, left partial arytenoidectomy was performed using an extralaryngeal approach. The left-to-right hemilaryngeal...
Epiglottic augmentation by use of polytetrafluoroethylene to correct dorsal displacement of the soft palate in a standardbred horse. A 2-year-old 400-kg Standardbred colt with a history of exercise intolerance was determined to have dorsal displacement of the soft palate (DDSP). Standing endoscopy revealed a soft, flaccid, and hypoplastic epiglottis and arytenoid cartilages that moved symmetrically and abducted fully. Lateral laryngeal radiography was used to calculate a corrected thyroepiglottic length of 6.48 cm. Videoendoscopy during exercise on a high-speed treadmill at standardized treadmill speeds was performed weekly for 3 consecutive weeks. The soft palate dorsally displaced at each examination. A sternohyoideus/ste...
Histologic evaluation of nerve muscle pedicle graft used as a treatment for left laryngeal hemiplegia in standardbreds. A nerve muscle pedicle (NMP) graft was placed in the cricoarytenoideus dorsalis (CAD) muscle of 6 horses with induced left laryngeal hemiplegia. The NMP graft was created by use of the first cervical nerve and omohyoideus muscle. In 1 horse (control), the first cervical nerve was transected after placement of the NMP graft. One year after the surgical procedure, horses were examined endoscopically and then anesthetized. While the larynx was observed endoscopically, the first cervical nerve was stimulated. Horses were subsequently euthanatized, and the larynx was harvested. Prior to anesthesia,...
Paralaryngeal accessory bronchial cyst as a cause of laryngeal haemiplegia in a horse. LARYNGEAL haemiplegia is common in horses and most often
involves the left haemilarynx (Baker 1983; Haynes 1984).
Although specific processes have been incriminated in the
pathogenesis of laryngeal haemiplegia, most cases involve an
idiopathic distal axonopathy of the recurrent laryngeal nerve. The
purpose of this report is to describe a case of laryngeal
haemiplegia associated with an anomalous respiratory cyst. A
description of the lesion, method of surgical repair of the
laryngeal collapse and a proposed term to describe the
abnormality based on pathological and functional consider...
Attempted reinnervation of the equine larynx using a muscle pedicle graft. Laryngeal hemiplegia was induced in 4 ponies via a left recurrent laryngeal neurectomy. Reinnervation of the denervated left cricoarytenoideus dorsalis muscle was then attempted using a muscle pedicle graft from the right cricoarytenoideus dorsalis muscle. In 3 ponies there was no return of abductor function and failure of graft survival. In the fourth pony there was return of abductor function along with survival of the muscle bridge, however, there was evidence of reinnervation across the neurectomy site. Muscle-to-muscle neurotization of the paralyzed equine larynx, utilizing the cricoaryte...
Determination of the early age of onset of equine recurrent laryngeal neuropathy. 1. Muscle pathology. 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...
Determination of the early age of onset of equine recurrent laryngeal neuropathy. 2. Nerve pathology. The left and right recurrent laryngeal nerves and peroneal nerves from two groups of foals, one less than 1 month of age and the other 6 months of age, were examined by light and electron microscopy. While there was no evidence of fiber loss on light microscopy, occasional onion bulbs, regenerating clusters and swollen axons were seen in the recurrent laryngeal nerves. To quantitate these changes, total counts of the main pathological structures were performed using the electron microscope. In all the foals the most common abnormality seen in the laryngeal nerves were Bungner bands, which were...
Treatment of left laryngeal hemiplegia in standardbreds, using a nerve muscle pedicle graft. The efficacy of a nerve muscle pedicle (NMP) graft in restoring upper airway function was evaluated in exercising horses with induced left laryngeal hemiplegia. The NMP graft was created from the first cervical nerve and the omohyoideus muscle and transplanted into the left cricoarytenoideus dorsalis muscle. Seven adult Standardbreds were trained to exercise on a treadmill inclined at 6.38 degrees. With the horses at rest and exercising at 4.2 and 7.0 m/s, the following variables were recorded: peak inspiratory and expiratory transupper airway pressures (defined as the pressure difference betw...
Dynamic evaluation of the equine upper respiratory tract. Each case of suboptimal equine athletic performance should be evaluated in a comprehensive manner, including physical examination; clinical pathologic analysis; and evaluation of the neurologic system, the musculoskeletal system, and the upper and lower respiratory system. A vital part of this examination is the clinical evaluation of dynamic upper respiratory tract function of the horse during treadmill exercise, which allows the observation of upper respiratory tract function during conditions simulating competitive racing. It generally is agreed that the endoscopic identification of an uppe...
The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part I: Subjective and objective laryngeal evaluation. Videorecordings of the laryngeal activity of 108 unsedated horses were obtained at rest by passing a flexible videoendoscope into the nasopharynx through the right ventral meatus. All videotaped images were reviewed once, and 72 were reviewed twice, by three veterinarians. Laryngeal cartilage movement was assessed subjectively with a five-tier grading system. The mean intraobserver agreement was 83.3% (range, 75.0%-90.2%) with a kappa statistic of .65 to .98. The mean interobserver agreement was 79.0% (range, 70.4%-80.6%) with a kappa statistic of .51 to .90. A computer program was developed t...
Liver failure attributable to pyrrolizidine alkaloid toxicosis and associated with inspiratory dyspnea in ponies: three cases (1982-1988). Of 41 equids referred to a veterinary teaching hospital in the Pacific northwest because of dyspnea and inspiratory noise, 3 ponies were diagnosed as having liver failure, most likely attributable to pyrrolizidine alkaloid toxicosis. Dyspnea appeared to be caused by laryngeal and/or pharyngeal paralysis. It is proposed that this paralysis was a manifestation of hepatic encephalopathy. Although these clinical signs are not common for pyrrolizidine toxicosis, practitioners should be aware of the possibility so that misdiagnosis of other causes of inspiratory dyspnea may not be made.
Endoscopic findings in the upper respiratory tract of 678 Thoroughbred racehorses. The frequency of upper respiratory tract abnormalities was determined in a selected population of racing Thoroughbreds. The prevalence of pharyngeal lymphoid hyperplasia was 34.2%; left laryngeal hemiplegia was 1.8%; and epiglottic entrapment was 0.74%. Excluding pharyngeal lymphoid hyperplasia and tracheal exudate, 3.7% of the population examined had upper respiratory tract abnormalities.
A comparison of techniques to enhance the evaluation of equine laryngeal function. This study was designed to define a simple, unequivocal test for the evaluation of laryngeal function and the diagnosis of idiopathic laryngeal hemiplegia (ILH). ILH is a disorder that results from left recurrent laryngeal neuropathy and in which there is no movement of the left arytenoid cartilage and vocal fold. Laryngeal function was evaluated in seven horses using four techniques designed to stimulate laryngeal movements:-nasal occlusion, exercise, swallowing and administration of a respiratory stimulant. In addition, the effects of sedation and twitching on the endoscopic examination were...
Arytenoid cartilage movement in resting and exercising horses. Endoscopic examinations of the larynx were recorded on 49 horses at rest and while exercising on a 5% inclined high-speed treadmill for 8 minutes at a maximum speed of 8.5 m/sec. Subjective laryngeal function scores at rest and while exercising were based on the degree and synchrony of arytenoid abduction. Arytenoid abduction was expressed as a left:right ratio of rima glottidis measurements. Horses with arytenoid cartilage asynchrony at rest (grade 2) could not be distinguished from normal horses (grade 1) when exercising because full abduction was maintained throughout the exercise period. F...
Preferential denervation of the adductor muscles of the equine larynx. II: Nerve pathology. The terminal branches of the recurrent laryngeal nerve (RLN) of three normal ponies and six horses with sub-clinical laryngeal disease were examined qualitatively and quantitatively in an attempt to explain the preferential denervation of the laryngeal adductor muscles in the neuropathy of idiopathic laryngeal hemiplegia (ILH). The myelinated fibre spectra of all the motor nerve fibres in the left and right abductor and adductor branches of the RLN in three normal ponies were measured. The density of myelinated fibres was also calculated. There was no significant difference between the larger ...
Bilateral arytenoid cartilage paralysis after inhalation anesthesia in a horse. An 8-year-old Quarter Horse gelding was anesthetized for surgical exploration and debridement of a chronic draining wound in the intermandibular space. Anesthesia was without complication other than persistently low PaO2. Severe airway obstruction was evident immediately after extubation, requiring tracheostomy. Endoscopic diagnosis was bilateral arytenoid paralysis, which gradually resolved over the next 7 days. Compression, trauma, or tension of the recurrent laryngeal nerves are the postulated causes of idiopathic laryngeal hemiplegia in horses. The extremely extended position of the head a...
Laryngeal hemiplegia in draft horses. A review of 27 cases. Case records of 27 draft horses with laryngeal hemiplegia were reviewed. Twenty-one horses were treated by ventriculectomy with or without prosthetic laryngoplasty, and 17 owners were contacted to determine the results. Fifteen horses improved after surgery and were able to perform to the owners' expectations. Performance improved significantly and hospitalization was shorter after ventriculectomy alone. Results of this study indicate that the clinical signs of exercise intolerance and excessive inspiratory noise associated with left laryngeal hemiplegia in draft horses can be treated successf...
Failure of subtotal arytenoidectomy to improve upper airway flow mechanics in exercising standardbreds with induced laryngeal hemiplegia. Upper airway flow mechanics and arterial blood gas measurements were used to assess the efficacy of subtotal arytenoidectomy for treatment of induced left laryngeal hemiplegia in horses. Measurements were collected with the horses at rest, and trotting or pacing on a treadmill (6.38 degrees incline) at speeds of 4.2 and 7.0 m/s. Experimental protocols were performed after right common carotid artery exteriorization (baseline), after left recurrent laryngeal neurectomy (LRLN), and after left subtotal arytenoidectomy. At baseline, increasing treadmill speed progressively increased peak inspirato...
Horner’s syndrome in the horse: a clinical, experimental and morphological study. A clinical case of Horner's syndrome is described in a Standardbred horse, and the various symptoms of cranial sympathetic denervation are studied in two ponies after experimental transection of the left cervical sympathetic trunk and vagosympathetic trunk, respectively. The most prominent symptoms of equine Horner's syndrome were ptosis, local sweating and increased cutaneous temperature in the denervated area. Enophthalmos, miosis and increased lacrimation were also observed but these symptoms were mild, variable and difficult to ascertain. Prolapse of the third eyelid was not noticed. Conco...
Transendoscopic Nd:YAG laser surgery for treatment of epiglottal entrapment and dorsal displacement of the soft palate in the horse. Transendoscopic neodymium:yttrium-aluminum-garnet (Nd:YAG) laser was used to treat 12 standing horses with epiglottic entrapment (EE) or dorsal displacement of the soft palate (DDSP), or both. In four horses, transendoscopic laser staphylectomy was performed. The most common presenting complaints were respiratory stridor, cough, and exercise intolerance. Ten horses with EE healed without epiglottic complications; in one horse, partial adhesion of the aryepiglottic fold to one side of the epiglottis was corrected surgically through a laryngotomy incision. One horse with DDSP had no further sign...
Preliminary study of laryngeal sacculectomy in horses, using a neodymium:yttrium aluminum garnet laser technique. In an attempt to ablate the laryngeal saccule as an alternative method of sacculectomy (conventially done through a laryngotomy incision for laryngeal hemiplegia) a neodymium:yttrium aluminum garnet laser was used transendoscopically in noncontact fashion in 6 horses. The procedure was easy, quick, and labor-saving, with few complications. Endoscopically, the lased sacculectomy site appeared healed at postsurgical day 42. On postsurgical day 42, microscopic examination revealed mucosal remnants under the granulation bed. Laser energy caused thermal damage to tissues adjacent to the lased saccu...
Upper airway function during maximal exercise in horses with obstructive upper airway lesions. Effect of surgical treatment. Upper airway pressure was measured during maximal exercise in 10 Thoroughbred racehorses with naturally occurring upper airway obstruction. Left laryngeal hemiplegia and arytenoid chondropathy resulted in substantial increases (30-40 cm H2O) in inspiratory upper airway pressure (Pl), whereas complicated aryepiglottic entrapment and subepiglottic cysts produced only modest increases (15 cm H2O) in Pl. Uncomplicated aryepiglottic entrapment and grade IV pharyngeal lymphoid hyperplasia produced only slight increases (3-5 cm H2O). In general, surgical procedures restored airway pressures to within...
Evaluation of upper respiratory tract function during strenuous exercise in racehorses. Forty-six racehorses with a history of poor performance underwent endoscopic evaluation of laryngeal and pharyngeal function while exercising on a high-speed treadmill. This evaluation allowed the definitive diagnosis of intermittent or continual upper respiratory tract obstruction as a cause of poor performance, as well as the documentation of the dynamic functional anatomy of the obstruction. Ten of the horses (22%) were determined to have a functional abnormality of the upper respiratory tract. These abnormalities included epiglottic entrapment (1 horse), persistent dorsal displacement of t...
Clinical evaluation of laryngeal sensation in horses. Sensory innervation of the larynx was examined by tactile stimulation with a blunt biopsy forceps passed through a flexible videoendoscope. Twenty horses with no evidence of laryngeal motor deficit were stimulated on 10 sites by touch with the forceps. Unilateral neurectomies of the internal branch of the left cranial laryngeal nerve were performed on 5 other horses. These horses were stimulated by touch on the same sites preoperatively and up to 1 week postoperatively. In all 25 horses the motor response of the larynx was recorded on videotape and evaluated by 2 observers blind as to treatmen...