The larynx in horses is a complex anatomical structure located in the throat, playing a critical role in respiration, phonation, and airway protection. It consists of cartilages, muscles, and ligaments that work together to regulate airflow into the trachea and produce vocal sounds. The equine larynx is susceptible to various conditions, such as laryngeal hemiplegia, which can impact a horse's breathing and performance. This page aggregates peer-reviewed research studies and scholarly articles that explore the anatomy, function, disorders, and clinical management of the larynx in horses, providing insights into diagnostic techniques and therapeutic interventions.
Duncan ID, Baker GJ, Heffron CJ, Griffiths IR.The larynges of 6 horses were examined endoscopically and the findings correlated with the gross and histological appearance of the intrinsic laryngeal muscles and their nerve supply. In all cases it appeared that the balance between abductor and adductor muscle groups had been lost due to preferential atrophy of individual muscles or groups of muscles. The laryngeal abnormalities recorded were asymmetry of the larynx with asynchronous left sided abduction and fluttering or trembling of the left vocal cord and arytenoid cartilage. It is suggested that these changes represent the early signs of...
Gunson DE, Rooney JR.An 8-year-old gelding with a long-standing, streptococcal respiratory infection developed dyspnoea and colic. Laparotomy disclosed numerous, discrete, hemorrhagic, thick areas of necrosis throughout the intestinal tract. At postmortem examination similar lesions were seen in the laryngeal mucosa and in many skeletal muscles. Microscopically these lesions had massive necrosis and hemorrhage with a leucocytoclastic vasculitis in adjacent tissue. This condition resembled anaphylactoid purpura (Henoch-Schönlein disease) in man. Fungal infection was ruled out by special stains which failed to show...
Ordidge RM.The diagnosis and surgical correction of epiglottic entrapment is described. Four cases are presented each with a different history. They serve to illustrate that the aetiology is complex, being either congenital or acquired. The use of a thorough endoscope examination is stressed in order to successfully diagnose this condition.
Willoughby RA, MacDonald E, McSherry BJ, Brown G.Groups of young growing horses were fed toxic amounts of lead only, zinc only and the same amounts of lead and zinc together. Those fed Pb only developed pharyngeal and laryngeal paralysis ("roaring") whereas those fed Zn only and Pb and Zn together developed the same clinical syndrome which included swelling at the epiphyseal region of the long bones, stiffness and lameness. Anemia and decreased weight gains were most pronounced in animals fed Zn for the longest periods. Animals fed Pb only did not become anemic and weight loss did not occur until after there was an interference in swallowing...
Almonte H, Schumacher J, Johnson CR, Berk JT, Bell RP.To the authors' knowledge, the effect of a combination of butorphanol tartrate and detomidine hydrochloride on the laryngeal function and symmetry of the arytenoid cartilages in young Thoroughbred horses has not been examined. Therefore, this study aimed to examine the effects of administration of butorphanol and detomidine on left-to-right rima glottidis ratio (L:R RGR), cross-sectional area of the rima glottidis (CSARG) and grade of laryngeal function of Thoroughbred yearlings examined endoscopically at rest. Forty-six Thoroughbred yearlings underwent laryngeal video endoscopy, at rest, befo...
Tatarniuk DM, Carmalt JL, Allen AL.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...
Tate LP, Newman HC, Cullen JM, Sweeney C.Laryngeal surgery in the equine is customarily and routinely performed by means of a ventral laryngotomy incision. Such procedures are usually performed under deep general anesthesia with the horse in dorsal recumbency. The objective of this work was to determine the efficacy of an endoscopic approach coupled to a Nd:YAG laser fiber in performing arytenoidectomy. Arytenoidectomy is commonly indicated in the treatment of arytenoid chondritis and in the failure of prosthetic implantation for left laryngeal hemiplegia. This preliminary study was undertaken to determine the feasibility of the endo...
Chesworth M, Brandenberger O, Cheetham J, Windley Z, Schumacher J, Cochran K, Piercy RJ, Perkins JD. To investigate the effect of the transverse arytenoid ligament (TAL) on abduction of the arytenoid cartilage when performing laryngoplasty. Modified prosthetic laryngoplasty was performed on right and left sides of 13 cadaver larynges. Increasing force was sequentially applied to the left arytenoid cartilage at 3 N intervals from 0-24 N, when the force on the right arytenoid cartilage was either 0 or 24 N, before and after TAL transection. Digital photographs of the rostral aspect of the larynx were used to determine the left arytenoid abduction angles for these given force combinations and ...
O'Rielly JL, Beard WL, Renn TN, Padden AJ, Hinchcliff KW.To investigate the effect of combined staphylectomy and laryngotomy on upper airway mechanics in clinically normal horses running on a treadmill. Methods: 6 Standardbreds. Methods: Upper airway mechanics were measured with horses trotting or pacing on a treadmill at 5, 8, and 10 m/s before and 6 weeks after combined staphylectomy and laryngotomy. Pharyngeal and tracheal inspiratory and expiratory pressure were measured by use of transnasal tracheal and pharyngeal side hole catheters connected to differential pressure transducers. A pneumotachograph mounted on the rostral end of an airtight fac...
Speirs VC, Bourke JM, Anderson GA.Four variations of abductor muscle prosthesis for treating laryngeal hemiplegia were evaluated in 153 horses by questionnaire, and in the 100 Thoroughbred racehorses in this group survival analysis was used to compare their racing performances and earnings with those of 400 control horses. The questionnaire indicated that the technique which included a ventriculectomy and 2 prostheses was regarded as being the most successful (P less than 0.01) and resulted in the least residual stertor (P less than 0.001). Survival analysis showed that there was no significant difference between the treated g...
Ahern BJ, Sole A, de Klerk K, Hogg LR, Vallance SA, Bertin FR, Franklin SH.Upper airway endoscopy of thoroughbred (TB) yearlings is commonly used in an attempt to predict laryngeal function (LF) and its impact on future race performance. The aim of this study was to determine if different grading systems and laryngeal grades were correlated with future performance. Methods: Postsale endoscopic recordings were obtained from an Australian TB yearling sale during a four-year period from 2008 to 2011. Horses were included if they had a diagnostic postsale video endoscopic recording and raced within Australia. Recordings were graded using the Havemeyer system and subseque...
Allen KJ, Franklin SH.To date there is no information on the comparison of the more recently documented technique of performing endoscopy during ridden exercise in the field, with the more traditional method of endoscopy during high-speed treadmill exercise. Objective: To compare the results of upper respiratory tract endoscopy in UK Thoroughbred racehorses performed during ridden exercise in the field with those obtained during exercise on the treadmill. Methods: A direct comparison was undertaken in 4 horses whereby both procedures were performed in the same horse within 10 days of each other. An indirect compari...
Woodie JB, Ducharme NG, Kanter P, Hackett RP, Erb HN.Correct placement of sutures ('laryngeal tie-forward') in experimentally created dorsal displacement of the soft palate (DDSP) has been observed to replace the function of the thyrohyoideus muscles and prevent DDSP. Objective: The 'laryngeal tie-forward' procedure would prevent or delay the occurrence of DDSP during exercise in horses with naturally occurring DDSP and therefore improve performance. Methods: A clinical population (n = 116), mainly of racehorses was presented for treatment of naturally occurring exercise-induced DDSP. All horses underwent the 'laryngeal tie-forward' procedure. T...
Tulleners EP, Harrison IW, Mann P, Raker CW.Left-sided partial arytenoidectomy was performed in eight horses to evaluate healing. Four horses underwent conventional partial arytenoidectomy with suture apposition of the mucosa. In four horses, most of the arytenoid cartilage, including overlying mucosa, vocal fold, and laryngeal saccule, were excised en bloc without mucosal closure. The horses were monitored clinically by endoscopic examination. One horse from each group was euthanatized at weeks 2, 4, 8, and 16. Complete necropsies with gross and histologic examination of the arytenoidectomy sites were performed. Postoperative complicat...
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 ...
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...
Heffron CJ, Baker GJ.Fibreoptic endoscopy was used to study the movements of the larynx and pharynx during nasal occlusion in 10 horses, which showed signs consistent with functional pharyngeal obstruction (FPO) on exercise. Cine-endoscopic films were made on 3 such horses. Consideration of the anatomy of the region indicates that FPO may best be regarded as a subluxation of the nasopharyngeal and larygneal airways and it was found that a constant component of the movements which brought about this subluxation was a marked caudal retraction of the larynx. It is suggested that this caudal retraction of the larynx o...
Tate LP.The advantages and disadvantages of various surgical lasers are discussed. Included are aspects of laser safety, anesthesia and analgesia considerations for laser surgery, and diagnostic considerations. Horses with lesions such as ethmoid hematomas, nasal polyps, and lymphoid masses are ideal candidates for laser treatment. Other conditions that are suitably treated with lasers, such as dorsal displacement of the soft palate and entrapment of the epiglottis, are described.
Ohnesorge VB, Deegen E, Jöchle W.Detomidine was used in this field trial effectively as a sedative and analgesic for laryngoscopic examinations in a total of 193 foals and 806 mature horses (Hanoverians). Detomidine was given either i.v. in foals 3 to 11 months old (20 micrograms/kg) and in mature horses (15 micrograms/kg), or i.m. in foals below 6 months of age (35 micrograms/kg). After i.v. administration, laryngoscopy was tolerated in more than 90% of all animals without additional use of a twitch, while in foals treated i.m. more than 70% required a twitch in order to enable this procedure. The effectiveness of detomidine...
Linford RL, O'Brien TR, Wheat JD, Meagher DM.A lateral radiograph of the pharyngeal region provides a technique for identifying pharyngeal disorders, including entrapment of the epiglottic cartilage and dorsal displacement of the soft palate. Epiglottic cartilage length, predicted from radiographs by measurement from the body of the thyroid cartilage to the tip of the epiglottis (thyroepiglottic length), was well correlated to actual length at postmortem examination (r2 = 0.98). Thyroepiglottic length, corrected for magnification, was 8.76 +/- 0.44 cm in 24 healthy Thoroughbreds. Nine Thoroughbreds with entrapment of the epiglottic carti...
Holcombe SJ, Derksen FJ, Berney C, Becker AC, Horner NT.To determine the effect of desensitization of the laryngeal mucosal mechanoreceptors on upper airway mechanics in exercising horses. Methods: 6 Standardbreds. Methods: In study 1, videoendoscopic examinations were performed while horses ran on a treadmill with and without topical anesthesia of the laryngeal mucosa. In study 2, peak tracheal and nasopharyngeal pressures and airflows were obtained from horses during incremental treadmill exercise tests, with and without topical anesthesia of the laryngeal mucosa. A nasal occlusion test was performed on each horse while standing during an endosco...
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...
Kane-Smyth J, Barnett TP, Mark O'Leary J, Dixon PM.To describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses. Methods: Retrospective case report. Methods: Thoroughbreds diagnosed with ventral glottic stenosis (n=2). Methods: Horses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise-related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, ...
Tetens J, Hubert JD, Eddy AL, Moore RM.A 2-year-old Thoroughbred filly was admitted to the hospital for evaluation of exercise intolerance. Resting videoendoscopic evaluation (i.e., while the horse was standing) of the nasopharynx and trachea revealed right arytenoid paresis and a tracheal defect that was 100 cm distal to the external nares. Surgery, consisting of a right prosthetic laryngoplasty, was performed. However, postoperative videoendoscopic evaluation revealed minimal abduction of the affected arytenoid cartilage. Dynamic videoendoscopic evaluation (i.e., while the horse was exercising) revealed the right arytenoid to be ...
Barakzai SZ, Wells J, Parkin TDH, Cramp P.Unilateral ventriculocordectomy (VeC) is frequently performed, yet objective studies in horses with naturally occurring recurrent laryngeal neuropathy (RLN) are few. Objective: To evaluate respiratory noise and exercising overground endoscopy in horses with grade B and C laryngeal function, before and after unilateral laser VeC. Methods: Prospective study in clinically affected client-owned horses. Methods: Exercising endoscopy was performed and concurrent respiratory noise was recorded. A left-sided laser VeC was performed under standing sedation. Owners were asked to present the horse for re...
Grzeskowiak R, Schumacher J, Omidi O, Bowers K, Cassone LMC, Abedi R, Hespel AM, Mulon PY, Anderson DE.To assess a three-dimensional (3-D)-printed laryngeal clamp (LC) designed to enhance the anchoring of laryngeal prostheses at the cricoid cartilage. Methods: Ex vivo biomechanical study. Methods: A total of 22 equine larynges. Methods: Two experimental groups included larynges with standard prosthetic laryngoplasty (PL; n = 10) and larynges with prosthetic laryngoplasty modified with laryngeal clamps (PLLC; n = 10). All constructs underwent 3000 cycles of tension loading and a single tension to failure. Recorded biomechanical parameters included maximum load, actuator displacement, a...
Scholler D, Wittenberg J, Zablotski Y, May A.The public perception relating to the welfare of horses involved with equestrian sports is associated with training methods used and the presentation of horses at events. In this context, very tight nosebands, which are intended to prevent the horse from opening its mouth, also attract a lot of attention. Various studies have evaluated the impact of tight nosebands on stress parameters, whereas the effect of tight nosebands on upper airway function is unknown. Therefore, the aim of the study was to use overground endoscopy to evaluate changes in pharyngeal and laryngeal function when a tight n...
Tahir AM, Guo L, Ward RK, Yu X, Rideout A, Hore M, Wang ZJ.Laryngeal hemiplegia (LH) is a major upper respiratory tract (URT) complication in racehorses. Endoscopy imaging of horse throat is a gold standard for URT assessment. However, current manual assessment faces several challenges, stemming from the poor quality of endoscopy videos and subjectivity of manual grading. To overcome such limitations, we propose an explainable machine learning (ML)-based solution for efficient URT assessment. Specifically, a cascaded YOLOv8 architecture is utilized to segment the key semantic regions and landmarks per frame. Several spatiotemporal features are then ex...
Hardwick J, Ahern B, Franklin S.Due to concerns about disagreement between veterinarians when grading resting laryngeal function (LF), a diagnostic decision tree (DDT) has been developed by codifying the Havemeyer grading system and objectively defining certain terms to remove ambiguity. Videoendoscopic examinations of the equine larynx that had previously been assigned a unanimous LF grade by 3 experienced observers were used to develop the DDT and determine the cut-off values. The DDT is a flow chart consisting of a series of dichotomous (yes/no) decisions, to dictate the order of decision making and direct the observer do...
Norton AM, Rosanowski SM, O'Brien T.Epiglottic entrapment (EE) is a common cause of poor performance in racing standardbreds (STBs) and thoroughbreds (TBs). There is limited information published on the condition in STB racehorses and limited information on factors associated with return to racing available for either breed. Unassigned: This study investigated and compared the pre surgical findings, post-surgical complications and racing performance in STBs and TBs undergoing surgery for correction of EE. Associations between signalment and pre-surgical findings, and the presence of complications and racing post-surgery were com...
McGivney CL, McGivney BA, Farries G, Gough KF, Han H, Holtby AR, MacHugh DE, Katz LM, Hill EW.Equine recurrent laryngeal neuropathy (RLN) is an economically important upper respiratory tract (URT) disease with a genetic contribution to risk, but genetic variants independent of height have not been identified for Thoroughbreds. The method of clinical assessment for RLN is critical to accurately phenotype groups for genetic studies. Objective: To identify genetic risk loci for RLN in Thoroughbreds in a genome-wide association study (GWAS) following high-resolution phenotyping. Methods: Case-control. Methods: Thoroughbred horses were characterised as RLN cases and controls using resting a...
Sholty KA, Hecobian A, Sullivan AP, Collett JL, Koch DW, Hackett ES.To evaluate plume composition during simulated diode laser equine upper airway surgery. Unassigned: A 980-nm diode laser fiber was applied in continuous-wave mode in contact with laryngeal and pharyngeal tissues of 6 equine cadaver heads, and resultant plumes were collected for analysis. Measured parameters included the real-time concentration of particulate matter under the size of 2.5 μm (PM2.5), organic carbon (OC), elemental carbon (EC), and volatile organic compounds (VOCs). Unassigned: Visible smoke was encountered during surgical laser application and plume collection. Diode laser medi...
Hardwick JL, Ahern BJ, Crawford KL, Allen KJ, Anderson BH, Rose KJ, Franklin SH.The relationship between Thoroughbred yearling laryngeal function (YLF) grade and race performance is unclear. Objective: To determine the effect of YLF on future race performance. Methods: Retrospective cohort study. Methods: Post-sale endoscopic recordings were reviewed from Australian yearling sales in 2018-2019. Race performance was evaluated for career and as 2-, 3- and ≥4-year-olds. Multivariable generalised linear modelling examined the association between YLF and performance, with risk estimates presented as coefficients (95% CI). Results: The YLF in 5175 examinations was graded I in...
England D, Newsom L, White C, McKenzie E.Site selection for cervical stabilization surgery in horses with spinal ataxia frequently relies on measurements derived from radiographic myelography. A variety of measurement criteria exist and can provide conflicting results. The main objectives of this study were to assess the correlation between two commonly used myelographic measures, dorsal contrast column reduction (DCCR) and dural diameter reduction (DDR), and their association with previously selected operative sites in a population of horses operated at a tertiary clinic. Secondary objectives were to determine if articular process j...
