Laryngoplasty is a surgical procedure performed on horses to address laryngeal hemiplegia, commonly known as "roaring." This condition involves the partial paralysis of the arytenoid cartilage, leading to impaired airflow and abnormal respiratory noise during exercise. Laryngoplasty aims to improve airway function by surgically stabilizing the arytenoid cartilage in an abducted position, thereby enhancing airflow and reducing noise. The procedure is typically performed on performance horses to improve their athletic capabilities. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and postoperative management associated with laryngoplasty in horses.
Brandenberger O, Martens A, Robert C, Wiemer P, Pamela H, Vlaminck L, Barankova K, Haspeslagh M, Perkins JD, Ducharme N, Rossignol F.To describe the anatomy of the entry to the equine esophagus (vestibulum esophagi) and to assess the risk of penetrating its adventitia and/or lumen during laryngoplasty. Methods: Ex vivo cadaveric study. Methods: Five isolated equine larynges and 39 equine head and neck specimens. Methods: The anatomy of the vestibulum esophagi was studied by dissection of 5 cadaver specimens. Then, a bilateral laryngoplasty was performed, including 5 suture placements through the muscular processes, caudal, rostral, and sagittal, with straight and curved needles. Two of the 3 surgeons performing the implanta...
Ahern BJ, Lim YW, van Eps A, Franklin S.To determine the effect of a prototype dynamic laryngoplasty system (DLPS) on arytenoid abduction. Methods: In vitro experimental. Methods: Ten equine larynges. Methods: Dissected larynges were mounted, and the right arytenoid was maximally abducted for testing. A left-sided laryngoplasty (LP) was performed by using a strand of No. 2 FiberWire and a FASTakII anchor. Phase 1 involved tightening the suture, without the DLPS device in place, in 1-mm increments and acquiring a digital image of the rima glottidis at each increment. Phase 2 involved tying the suture with the DLPS in place at a left ...
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...
Vidovic A, Delling U.Coughing and dysphagia have been described following prosthetic laryngoplasty (LP) with or without ventriculectomy/ventriculocordectomy (VE/VCE) for the treatment of recurrent laryngeal neuropathy. All previous case descriptions include patients with acute onset of clinical signs after surgery that persisted. The authors observed a late-onset of dysphagia and coughing months to years after LP ± VE/VCE. The condition was always associated with an abnormality of the aryepiglottic fold (AEF). Treatment options for those patients are limited. We suggest augmentation of the AEF as treatment for ...
Brandenberger O, Rossignol F, Perkins JD, Lechartier A, Mespoulhès-Rivière C, Vitte A, Rossignol A, Ducharme N, Boening KJ.To determine the biomechanical properties of 5 suture constructs in the equine cricoid under cyclic loading and load to failure testing. Methods: Ex vivo study. Methods: Seventy-five equine cadaver larynges. Methods: Each larynx was implanted with 1 of 5 cricoid-suture constructs. The standard laryngoplasty, where a suture is passed once through the cricoid, including its caudal edge, was used in 2 constructs: 1 with 5 USP Ethibond (ES) and 1 with 2 mm Fibertape (FS). In the third construct, the 2 mm Fibertape was passed twice through the cricoid including its caudal edge (Double Loop-DL). Con...
Ahern BJ, Van Eps AW, Boston RC, Franklin SH.To determine the degree and ease of arytenoid abduction achieved with abaxial placement of a FASTak II suture anchor compared to 2 suture patterns with different directions of insertion-caudomedial to craniolateral and medial to lateral. Methods: Ex vivo experimental. Methods: Cadaveric larynges from 10 Standardbred racehorses. Methods: Each larynx was sequentially instrumented with all 3 arytenoid suture attachment in random order: (1) abaxial placement of a FASTak II suture, (2) caudomedial to craniolateral suture, and (3) medial to lateral suture placement. Each construct was abducted at 5N...
Markwell HJ, Mueller PO.To evaluate the properties of a ZipFix(®) (ZipFix) implant in equine laryngeal cartilages. Methods: Ex vivo biomechanical study. Methods: Equine arytenoid (n=36) and cricoid cartilages (n=18). Methods: Suture bites were placed in arytenoid or cricoid cartilages using a ZipFix(®) implant or a single strand of USP 5 braided polyester (TiCron™), and arytenoid and cricoid cartilages were separately subjected to single load to failure (25 N preload) or cyclic loading for 1,000 cycles, followed by single load to failure. Load, distraction, and stiffness were recorded. Results: Four arytenoid-Zip...
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...
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: ...
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...
Barnett TP, Hawkes CS, Dixon PM.To report a resection and anastomosis technique to treat trauma-induced tracheal stenosis. Methods: Case report. Methods: A 9-year-old Warmblood gelding. Methods: Endoscopy, radiography, and ultrasonography were used to diagnose a single ring tracheal stenosis; the stenotic region was resected and adjacent tracheal rings anastomosed with an end-to-end technique. Results: The anastomosis healed completely despite formation of a unilateral partial mucosal stenosis "web," which was subsequently removed by transendoscopic laser surgery. During tracheal anastomosis, the left recurrent laryngeal ner...
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...
Lechartier A, Rossignol F, Brandenberger O, Vitte A, Mespoulhès-Rivière C, Rossignol A, Boening KJ.To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. Methods: Experimental ex vivo study. Methods: Equine larynges (n = 60). Methods: A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. Results: Mean ± SD distraction in cyclic loading was greater for D...
Willsallen H, Heller J, Kark L, Hilbert BJ.In vitro comparison of the mechanical properties of braided polyurethane elastomer (Lycra®) and braided polyester (Ethibond™) (1) when inserted into the muscular process of the arytenoid cartilage and (2) as suture loops. Methods: Experimental. Methods: Equine cadaver larynges (n = 15). Methods: The muscular processes (n = 30) of the arytenoid cartilages were dissected from each larynx and embedded in a resin base. Lycra® and Ethibond™ prostheses were randomly allocated to the left or right muscular process and each underwent cyclic fatigue (25-50 N) followed by load-to-failure...
McClellan NR, Santschi EM, Hurcombe SD, Litsky AS.To (1) develop a model of cyclical adduction force on an abducted left arytenoid cartilage that mimics swallowing or coughing; (2) determine if arytenoid abduction by a clamp before knot tying will improve the maintenance of abduction under cyclical adduction testing. Methods: Experimental. Methods: Cadaveric equine larynges (n = 14). Methods: Left laryngoplasty performed using a single suture of #5 Ethibond with (n = 7) and without (n = 7) abducting the arytenoid with a clamp before knot tying. Each laryngoplasty was loaded cyclically from 2 to 26 N at 0.5 Hz for 5000 cycles i...
Barakzai SZ, Dixon PM, Hawkes CS, Cox A, Barnett TP.To describe a complication observed endoscopically in horses after prosthetic laryngoplasty (LP). Methods: Case series. Methods: Horses (n = 5) that had previous LP. Methods: Four horses had endoscopic examination as part of a larger prospective study and had saliva emanating from their upper esophageal opening. One other horse was referred with clinical signs of severe upper esophageal obstruction 2 months after LP. Results: Four horses were observed to have saliva emanating from their upper esophageal opening during endoscopic examination 21-58 months after LP. Esophageal reflux was note...
Hawkins JF, Couetil L, Miller MA.The objective was to evaluate CO2 laser debridement of the cricoarytenoid joint (CAJ) combined with prosthetic laryngoplasty to prevent post-operative loss of arytenoid abduction in seven horses. Horses were assigned to either laser debridement of the left CAJ and laryngoplasty (laser treated, n=5) or control laryngoplasty (sham, n=2), and were evaluated with endoscopic examinations and measurement of right to left angle quotients (RLQ) to assess maintenance of arytenoid abduction. The animals were euthanased at intervals after surgery and larynges were harvested for post-mortem testing, inclu...
Barnett TP, O'Leary JM, Dixon PM, Barakzai SZ.Dorsal displacement of the soft palate (DDSP) in the horse has been previously described as intermittent, typically occurring at fast exercise; or persistent, seen at rest. Dorsal displacement of the soft palate has recently been reported following laryngoplasty (LP) and can be associated with continued poor performance and respiratory noise. Objective: The current study aimed to characterise the DDSP diagnosed post LP. Methods: Cross-sectional study. Methods: Owners/trainers of horses undergoing LP at one institution over 6 years were contacted to determine the horse's progress and willingnes...
Compostella F, Tremaine WH, Franklin SH.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...
Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ.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 ...
Bischofberger AS, Hadidane I, Wereszka MM, Perkins NR, Jeffcott LB, Dart AJ.To determine the effect of horse age and laryngeal prosthesis location on rima glottidis area in cadaveric larynges. Methods: Experimental study. Methods: Cadaveric equine larynges (n = 40). Methods: Specimens were grouped by age: group 1, ≤5 years (n = 18); group 2, >5 to ≤10 years (n = 12); group 3, >10 years (n = 10). A cranial prosthesis was placed through the dorsal cricoid spine at 70% of the distance of the total cricoid length measured from the caudal rim. A dorsal prosthesis was placed through the caudal rim of the cricoid on the dorsal midline. A lateral prosthesis was plac...
Bischofberger AS, Wereszka MM, Hadidane I, Perkins NR, Jeffcott LB, Dart AJ.To evaluate the effect of 3 laryngeal prostheses alone or in combination on rima glottidis area in horses. Methods: Experimental randomized design. Methods: Cadaveric equine larynges (n = 22). Methods: Three prostheses were preplaced in each of 14 larynges. Rima glottidis area was measured after loading each suture in 5 Newton (N) increments from 0 N to 35 N. In 8 larynges, the 3 prostheses were tied alone or in combination at a fixed load of 15 N and rima glottidis area measured. Results: Rima glottidis cross-sectional area increased as the load on each prosthesis increased with maximum area ...
Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ.To investigate upper respiratory tract function in horses, previously undergoing laryngoplasty (LP), using exercising video-endoscopy. Objective: To evaluate arytenoid abduction and stability, diagnose any concurrent upper airway problems, and correlate these with the owners' perception of success. Methods: Horses undergoing LP during a 6-year period at one hospital were initially included. Those available for re-examination were exercised for a duration and intensity considered maximal for their discipline using an over-ground endoscope. Resting and exercising laryngeal and pharyngeal videos ...
Ahern BJ, Boston RC, Parente EJ.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...
Rossignol F, Ouachée E, Boening KJ.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 ...
Mason BJ, Riggs CM, Cogger N.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...
Aceto H, Parente EJ.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 ...
Hardcastle MR, Pauwels FE, Collett MG.To report morphologic findings associated with laryngoplasty failure in a horse. Methods: Clinical report. Methods: A 9-year-old Thoroughbred cross gelding. Methods: Necropsy and histopathology were performed on a horse that died peracutely during anesthetic recovery after correction of a right dorsal displacement of the ascending colon. Three weeks earlier the horse had left laryngoplasty and ventriculocordectomy. Results: Dissection of the larynx revealed that the laryngoplasty suture had pulled through the muscular process of the left arytenoid cartilage, which appeared grossly normal. Hist...
Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ.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 ...
Schumacher J, Wilson AM, Pardoe C, Easter JL.A prosthesis, composed of a steel cable and stress-reducing washers, was developed to prevent failure of laryngoplasty, a common treatment for horses affected by recurrent laryngeal neuropathy. Laryngoplasties were performed on 15 cadaveric larynges using a polyester suture on one side and the cable prosthesis on the other. Each prosthesis was distracted at a displacement rate of 20 mm/s using a servohydraulic materials testing machine until laryngoplasty failed. Distraction force and actuator displacement were recorded and analysed. All 15 laryngoplasties performed with a suture failed at the...
Shappell KK, Derksen FJ, Stick JA, Robinson NE.Effects of ventriculectomy and prosthetic laryngoplasty on upper airway flow mechanics and blood gas tensions in exercising horses with induced left laryngeal hemiplegia were assessed. Five adult horses were trained to stand, trot (4.5 m/s), and gallop (7.2 m/s) on a treadmill (6.38 degrees incline). Inspiratory and expiratory airflows (VImax, VEmax, respectively) were measured using a 15.2-cm diameter pneumotachograph in a face mask. Inspiratory and expiratory transupper airway pressures (PuI, PuE, respectively) were determined as pressure differences between barometric pressure and lateral t...
Ahern BJ, Van Eps AW, Boston RC, Franklin SH.To determine the degree and ease of arytenoid abduction achieved with abaxial placement of a FASTak II suture anchor compared to 2 suture patterns with different directions of insertion-caudomedial to craniolateral and medial to lateral. Methods: Ex vivo experimental. Methods: Cadaveric larynges from 10 Standardbred racehorses. Methods: Each larynx was sequentially instrumented with all 3 arytenoid suture attachment in random order: (1) abaxial placement of a FASTak II suture, (2) caudomedial to craniolateral suture, and (3) medial to lateral suture placement. Each construct was abducted at 5N...
Brown JA, Derksen FJ, Stick JA, Hartmann WM, Robinson NE.Laryngoplasty is the technique of choice for treatment of laryngeal hemiplegia, with the aim of improving airway function and/or eliminating respiratory noise. However, there are no quantitative data in the literature describing the effect of laryngoplasty on upper airway noise or its relationship to upper airway mechanics in horses with laryngeal hemiplegia. Objective: To determine whether laryngoplasty reduces respiratory noise in exercising horses with laryngeal hemiplegia; and to establish whether the degree of upper airway obstruction can be predicted by upper airway noise, or the degree ...
Ahern BJ, Parente EJ.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...
Greet TR, Baker GJ, Lee R.Using fluoroscopic techniques and videotape recordings, a study of normal deglutition was made in 2 ponies. Paryngeal function was studied at intervals after laryngoplasty on 1 animal and after a sham technique on the other. Two clinical cases of laryngeal paralysis, which had been treated by laryngoplasty, were also examined. In the 2 experimental ponies, liquid food passed into the lower respiratory tract post-operatively. One of the clinical cases appeared to swallow solid food normally, but some food material entered the larynx of the other horse. It is suggested that pharyngeal dysfunctio...
Mason BJ, Riggs CM, Cogger N.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...
Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ.To investigate upper respiratory tract function in horses, previously undergoing laryngoplasty (LP), using exercising video-endoscopy. Objective: To evaluate arytenoid abduction and stability, diagnose any concurrent upper airway problems, and correlate these with the owners' perception of success. Methods: Horses undergoing LP during a 6-year period at one hospital were initially included. Those available for re-examination were exercised for a duration and intensity considered maximal for their discipline using an over-ground endoscope. Resting and exercising laryngeal and pharyngeal videos ...
Russell AP, Slone DE.Medical records of 70 horses diagnosed with left laryngeal hemiplegia that were treated by use of prosthetic laryngoplasty combined with bilateral ventriculectomy were examined. Degree of arytenoid cartilage abduction that had resulted from the prosthesis had been graded before the horse was discharged from the hospital. Follow-up information through owner/trainer questioning was acquired for 55 horses. Information concerning the type and frequency of complications, if any, was recorded, along with a determination of owner/trainer satisfaction regarding surgical results. Race records were acqu...
McClellan NR, Santschi EM, Hurcombe SD, Litsky AS.To (1) develop a model of cyclical adduction force on an abducted left arytenoid cartilage that mimics swallowing or coughing; (2) determine if arytenoid abduction by a clamp before knot tying will improve the maintenance of abduction under cyclical adduction testing. Methods: Experimental. Methods: Cadaveric equine larynges (n = 14). Methods: Left laryngoplasty performed using a single suture of #5 Ethibond with (n = 7) and without (n = 7) abducting the arytenoid with a clamp before knot tying. Each laryngoplasty was loaded cyclically from 2 to 26 N at 0.5 Hz for 5000 cycles i...
Tucker ML, Sumner D, Reinink SK, Wilson DG, Carmalt JL.To compare laryngeal impedance, in terms of air flow and pressure, following arytenoid corniculectomy (COR) versus 3 other airway interventions (left-sided laryngoplasty with ipsilateral ventriculocordectomy [LLP], LLP combined with COR [LLPCOR], and partial arytenoidectomy [PA]) performed on cadaveric equine larynges with simulated left recurrent laryngeal neuropathy (RLN) and to determine whether relative laryngeal collapse correlated with the interventions performed. Methods: 28 cadaveric equine larynges. Methods: Each larynx in states of simulated left RLN alone and with airway interventio...
Gray SM, Gutierrez-Nibeyro SD, Couëtil LL, Horn GP, Kesler RM, McCoy AM, Stewart MC, Schaeffer DJ.To evaluate the airway mechanics of modified toggle LP constructs in an airflow chamber model and compare these to the airway mechanics of standard LP constructs. Methods: Ex-vivo experimental study. Methods: Fifty-one equine cadaveric larynges. Methods: Bilateral LP constructs were performed using a modified toggle (n = 23) or a standard (n = 21) LP technique. Constructs were tested in an airflow model before and after cyclic loading which was designed to mimic postoperative swallowing. The cross-sectional area (CSA), peak translaryngeal airflow (L/s), and impedance (cmH 0/L/s) were deter...
Kelly JR, Carmalt J, Hendrick S, Wilson DG, Shoemaker R.To compare biomechanical properties of 6 suture configurations using a large diameter polyester prosthesis in the muscular process (MP) of the arytenoid cartilage and to determine failure mode. Methods: Experimental study. Methods: Cadaveric equine larynges (n=121). Methods: Suture configurations (4 single, 2 double) were inserted, and then constructs were tested in a single-cycle to failure at a 100 mm/min distraction. Load deformation curves were generated to assess the biomechanical properties of each construct. A 1-way ANOVA was used to compare the mean differences in construct failure for...
Scherzer S, Hainisch EK.To report the use of a nylon suture system (Canine Cranial Cruciate Ligament Repair System; Securos Inc Veterinary Orthopedics) as a prosthesis for equine laryngoplasty. Methods: Experimental and prospective clinical study. Methods: Cadaver specimens (n = 5) and 7 horses with left laryngeal hemiplegia. Methods: A commercially available monofilament nylon suture system was implanted as a laryngeal prosthesis. Arytenoid cartilage abduction was achieved with a tensioning device applied to the suture prosthesis during transnasal endoscopic observation. Suture fixation was achieved with crimping cl...
Tate LP, Corbett WT, Bishop BJ, Foreman JH.The physiologic effects of exercise were studied in four horses with complete laryngeal hemiplegia. Right carotid arteries were surgically elevated to a subcutaneous position for percutaneous catheterization. Each horse was fitted with a device designed to obtain multiple arterial samples while the horse was exercised over a 1.6-km course. After each horse completed 10 test gallops, the laryngeal hemiplegia was treated using a laryngeal prothesis and ventriculectomy. The horses were then reconditioned, and the exercise test and sampling were repeated. Horses with laryngeal hemiplegia became ac...
Brandenberger O, Martens A, Robert C, Wiemer P, Pamela H, Vlaminck L, Barankova K, Haspeslagh M, Perkins JD, Ducharme N, Rossignol F.To describe the anatomy of the entry to the equine esophagus (vestibulum esophagi) and to assess the risk of penetrating its adventitia and/or lumen during laryngoplasty. Methods: Ex vivo cadaveric study. Methods: Five isolated equine larynges and 39 equine head and neck specimens. Methods: The anatomy of the vestibulum esophagi was studied by dissection of 5 cadaver specimens. Then, a bilateral laryngoplasty was performed, including 5 suture placements through the muscular processes, caudal, rostral, and sagittal, with straight and curved needles. Two of the 3 surgeons performing the implanta...
Rossignol F, Ouachée E, Boening KJ.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 ...
Barakzai SZ, Boden LA, Dixon PM.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...
Smith MA, Ross MW.To determine features of postoperative wound infection caused by Actinobacillus spp in horses undergoing clean, elective surgery and to evaluate bacterial susceptibility profiles of bacteria isolated. Methods: Retrospective study. Methods: 10 horses. Methods: Data were retrieved from medical records and the microbiology laboratory database. Results: 1,604 horses underwent clean, elective surgical procedures during the study period. Of these, 23 (1.43%) had postoperative wound infections, and Actinobacillus spp was isolated from 10 of these 23 (43%). Surgical procedures in these 10 horses inclu...
Morris TB, Lumsden JM, Dunlop CI, Locke V, Sommerauer S, Hurcombe SDA.The nociceptive blockade of locoregional anesthesia prior to surgical stimulation can decrease anesthetic agent requirement and thereby potential dose-dependent side effects. The use of an ipsilateral second and third cervical spinal nerve locoregional anesthetic block for prosthetic laryngoplasty in the anesthetized horses has yet to be described. Anesthetic records of 20 horses receiving locoregional anesthesia prior to laryngoplasty were reviewed and compared to 20 horses of a similar patient cohort not receiving locoregional anesthesia. Non-blocked horses were 11 times more likely to requi...
Rossignol F, Perrin R, Desbrosse F, Elie C.To compare in vitro the load necessary for a partial and complete rupture of the muscular process arytenoid cartilage when a suture prosthesis is positioned by a bone trocar versus a trocar point needle and to compare failure mode. Methods: Experimental using cadaver specimens. Methods: Larynges from 18 Thoroughbred race horses, aged 2-20 years. Methods: Arytenoid cartilages were separated randomly into 2 groups: group 1-suture prosthesis inserted directly through the muscular process using a curved trocar point needle and group 2-suture passed through a hole predrilled with a 3 mm bone trocar...
Ahern BJ, Lukas E, Lam K, Wilke E, Bertin FR, Van Eps A, Franklin S.To evaluate a prototype dynamic laryngoplasty system (DLPS) in a static airflow model. Methods: Experimental. Methods: Ten equine larynges. Methods: The right arytenoid was fixed in abduction in all specimens. A left-sided laryngoplasty was performed with No. 2 Fiberwire and a FASTakII anchor. Each larynx was tested in a static airflow model. The system was adjusted to a flow rate of 55 L/s and prelaryngeal pressure of 12 mm Hg prior to testing in maximal arytenoid abduction. In phase 1, the left suture was loosened, shortened, and tested in 3-mm steps from 0 to 30 mm. In phase 2, the su...
Barakzai SZ, Dixon PM, Hawkes CS, Cox A, Barnett TP.To describe a complication observed endoscopically in horses after prosthetic laryngoplasty (LP). Methods: Case series. Methods: Horses (n = 5) that had previous LP. Methods: Four horses had endoscopic examination as part of a larger prospective study and had saliva emanating from their upper esophageal opening. One other horse was referred with clinical signs of severe upper esophageal obstruction 2 months after LP. Results: Four horses were observed to have saliva emanating from their upper esophageal opening during endoscopic examination 21-58 months after LP. Esophageal reflux was note...
Pascoletti G, Pressanto MC, Putame G, Terzini M, Audenino AL, Zanetti EM.A number of surgical practices are aimed to compensate for tissue relaxation or weakened/atrophied muscles by means of suture prostheses/thread lifts. The success rate of these procedures is often very good in the short term, while it is quite variable among subjects and techniques in the middle-long term. Middle-long term failures are mostly related to suture distraction, loosening or wear, coming from repeated loading cycles. In this work, an experimental device to perform ex vivo tests on prosthetic sutures has been set up. An equine laryngoplasty has been used as a benchmark, being represe...
Luedke LK, Cheetham J, Mohammed HO, Ducharme NG.To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery. Methods: Retrospective. Methods: Horses treated for dysphagia after laryngeal surgery. Methods: Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short- and long-term follow-up were obtained. Chi-square and logistical regression were performed to correlate independent variables and outcomes. Results: Forty-four percent of ho...
King CM, Evans DL, Rose RJ.A standardised incremental exercise test was performed by 9 racehorses with idiopathic laryngeal hemiplegia (ILH), 1 horse with maxillary sinus cysts, 1 horse with epiglottic entrapment, 1 horse with a lesion on the vocal folds, and 1 horse with pharyngitis. Two of the horses with ILH were retested after laryngoplasty and ventriculectomy. The findings were compared with those from 20 normal racehorses. Heart rate, plasma lactate concentration, arterial blood gases, stride frequency, oxygen uptake (VO2) and carbon dioxide production were assessed during treadmill exercise on a +10% slope. The g...
Garber JL, Reef VB, Reimer JM, Evans LH.A 2-year-old Thoroughbred racehorse developed ventricular tachycardia after elective laryngoplasty and ventriculectomy were performed while anesthesia was maintained with halothane. During surgery, the horse became febrile and developed transient mild hypercarbia. The horse was treated with an IV infusion of quinidine gluconate. Continuous electrocardiographic monitoring was used to evaluate cardiac rhythm during treatment, and conversion was achieved after 12 hours of IV infusion. The inciting cause for the arrhythmia was not determined.
