Topic:Larynx
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.
External transcutaneous ultrasound technique in the equine cricoarytenoideus dorsalis muscle: Assessment of muscle size and echogenicity with resting endoscopy. Recent studies have assessed the cricoarytenoideus dorsalis muscle (CAD) using transoesophageal ultrasonography in equine recurrent laryngeal neuropathy (RLN). We assessed the CAD using the external transcutaneous ultrasound technique, which may constitute an easier method in horses. Objective: To evaluate ultrasonographic imaging of the left cricoarytenoideus dorsalis muscle (LCAD) and right cricoarytenoideus dorsalis muscle (RCAD) as a diagnostic tool for RLN using the transcutaneous ultrasound technique. Methods: Cross-sectional study. Methods: The axial plane thickness, cross-sectional are...
Complete resection of the alar folds in eight standing horses with a bipolar dividing and vessel-sealing device. To describe a resection technique of the alar folds in the standing horse. Methods: Retrospective case study. Methods: Eight Standardbred racing trotters. Methods: Horses in which alar fold collapse had been diagnosed between 2017 and 2018 were included in this study. All horses underwent alar fold resection under standing sedation and regional anesthesia with a bipolar electrosurgical open sealer/divider device (LigaSure). Intraoperative and postoperative complications were recorded. A Wilcoxon signed-rank test was used to compare differences in median prize money earning pre-surgery and post...
Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy. 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...
Evaluation of Dynamic Structural Disorders in the Upper Airways and Applied Rein Tension in Healthy Dressage Horses During Riding in Different Gaits and Head-Neck Positions. Flexion of the horse's head and neck during dressage riding reduces the pharyngeal lumen with the risk of increased upper airway resistance and upper airway obstructions. According to the Fédération Equestre Internationale, hyperflexion is achieved through force, whereas the position low-deep-round is nonforced. The objectives of this study were to evaluate (1) applied rein tension and (2) dynamic structural disorders in the upper airways in dressage horses in different gaits and different head-neck positions (HNPs). Overground endoscopy (OGE) and rein tension were evaluated in 13 clinically...
Ex vivo evaluation of arytenoid corniculectomy, compared with three other airway interventions, performed on cadaveric equine larynges with simulated recurrent laryngeal neuropathy. 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...
Transendoscopic correction of epiglottic entrapment with a silicone-covered laser guide and diode laser in 29 horses. To describe the use of a silicone-covered laser guide and diode laser for surgical correction of epiglottic entrapment and report postoperative outcomes in horses with epiglottic entrapment. Methods: Retrospective case series. Methods: Thoroughbred and standardbred racehorses (n = 29) with epiglottic entrapment. Methods: A silicone-covered laser guide was placed endoscopically to direct the diode laser cutting action during transection of the entrapping subepiglottic membrane and to act as a physical barrier between the membrane and the epiglottic cartilage. Postoperative complications and tra...
Complete upper airway collapse and apnoea during tethered swimming in horses. There is limited knowledge of the breathing strategy and impact on the patency of the upper respiratory tract (URT) in swimming horses. Objective: To describe the respiratory responses and endoscopic appearance of the URT during tethered swimming in horses. Methods: Prospective descriptive study. Methods: Ten race-fit horses, with no history of URT obstruction, were examined during tethered swimming. Endoscopic examination, heart rate, sound recordings and above and below water video recordings were obtained. Plasma lactate concentration was measured before and 5 min after swimming and trache...
Ultrasonographic findings post laryngoplasty in the horse. Laryngoplasty is commonly used to treat laryngeal hemiplegia in Thoroughbred racehorses. Evaluation of the success of the laryngoplasty is traditionally determined using endoscopy. Laryngeal ultrasonography and normal ultrasonographic appearance have been reported in the standing horse, but post-laryngoplasty and ventriculectomy ultrasonographic evaluation has limited literature coverage. A prospective case series of 10 Thoroughbred racehorses with left laryngeal hemiplegia was examined ultrasonographically and endoscopically prior to 3-10 days, 30-50 days, and 6-12 months after laryngoplasty ...
Surgical corrections and postsurgical complications of epiglottic entrapment in Thoroughbreds: 12 cases (2009-2015). Twelve Thoroughbred racehorses were diagnosed as epiglottic entrapment at the Korea Racing Authority equine hospital. Four different surgical correction techniques were used to treat epiglottic entrapment: the transnasal hook bistoury, transoral unshielded hook bistoury, transnasal shielded hook bistoury, and transendoscopic laser techniques. Eleven cases were surgically resolved eventually, with one case of recurrence. Five complications related to surgical correction occurred: a severe nasal passage laceration and bleeding (n=1), epiglottic laceration (n=1), epiglottis tip burns (n=2), and m...
Ex vivo investigation of the effect of the transverse arytenoid ligament on abduction of the arytenoid cartilage when performing equine laryngoplasty. 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 ...
Laryngeal squamous cell carcinoma and papilloma associated with Equus caballus papillomavirus 2 in a horse. A case of laryngeal squamous cell carcinoma (SCC) and squamous papilloma in a 19-year-old Thoroughbred stallion is described. The animal exhibited severe wheezing caused by laryngopharyngeal stenosis. Histological examination identified laryngeal, laryngotracheal, and guttural pouch tumor masses consisting of areas of SCC. In the epiglottic lesion, the overlying epithelium was replaced by papilloma cells, and superficial cells frequently had nuclear inclusion bodies that expressed oncoprotein E6, which is characteristic of high risk human papillomaviruses. The papillomatous epithelium was cont...
Race performance following epiglottic entrapment surgery in Thoroughbred yearlings. Epiglottic entrapment can occur in yearling Thoroughbreds (TB); however, race performance following surgical correction is unknown. Objective: To determine the race performance of horses treated surgically for epiglottic entrapment as yearlings as compared to an untreated cohort. A second objective was to identify risk factors for treated horses not racing post-operatively. Methods: Retrospective cohort and case-control studies. Methods: Medical (1989-2014) and race records of 66 treated TB racehorses were reviewed. Observed abnormalities on pre- and post-operative endoscopic images and surgic...
Epiglottopexy for the treatment of epiglottic retroversion in 2 horses. To report an epiglottopexy technique for the treatment of epiglottic retroversion (ER) in 2 horses. Methods: Case report. Methods: A 2-year-old thoroughbred gelding and a 6-year-old standardbred gelding, both with ER. Methods: Epiglottic retroversion was diagnosed via exercising endoscopic examination in both horses. Epiglottopexy technique was performed in both cases. Results: Both horses returned to previous racing class within 1 year after surgery. Repeat exercising endoscopy of 1 horse 6 months postoperatively revealed resolution of the ER. Conclusions: Epiglottopexy should be consider...
Transcutaneous Ultrasonography Is a Feasible Method for Characterizing the Cricoarytenoideus Dorsalis Muscle in Horses. Assessment of the cricoarytenoideus dorsalis muscle (CAD) in horses using a transesophageal ultrasound, computed tomography, or magnetic resonance imaging is available in a limited number of hospitals. This study assessed the ease of ultrasonographic imaging of the CAD using an external transcutaneous technique in horses. After confirmation of the CAD in the cadavers, ultrasonography in twenty live horses was carried out using a transcutaneous approach. In live horses, ultrasonographic imaging of the CAD was possible by pushing the larynx from the opposite side with the other hand. It is belie...
Partial arytenoidectomy in 14 standing horses (2013-2017). To report our experience with partial arytenoidectomy in sedated standing horses. Methods: Retrospective study. Methods: Fourteen client-owned adult horses. Methods: The medical records (2013-2017) of horses treated with unilateral partial arytenoidectomy while standing and sedated were reviewed. Demographics, endoscopic findings, previous treatments, and outcome after surgery were investigated and recorded. Results: Thirteen horses had unilateral left-sided recurrent laryngeal neuropathy (RLN) and 1 horse had bilateral RLN. Five horses had a previous failed prosthetic laryngoplasty. Left-side...
Asymmetric recurrent laryngeal nerve conduction velocities and dorsal cricoarytenoid muscle electromyographic characteristics in clinically normal horses. The dorsal cricoarytenoid (DCA) muscles, are a fundamental component of the athletic horse's respiratory system: as the sole abductors of the airways, they maintain the size of the rima glottis which is essential for enabling maximal air intake during intense exercise. Dysfunction of the DCA muscle leads to arytenoid collapse during exercise, resulting in poor performance. An electrodiagnostic study including electromyography of the dorsal cricoarytenoid muscles and conduction velocity testing of the innervating recurrent laryngeal nerves (RLn) was conducted in horses with normal laryngeal fu...
Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses. To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. Methods: In vivo experimental study. Methods: Nine horses donated for medical conditions unrelated to respiratory system. Methods: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postopera...
Evaluation of a prototype dynamic laryngoplasty system in vitro with an equine vacuum airflow system. 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...
Moffett’s muted mules: the science of laryngology in the art of war. Mules and other equine species have been used in warfare for thousands of years to transport goods and supplies. Mules are known for 'braying', which is disadvantageous in warfare operations. This article explores the fascinating development of surgical techniques to stop military mules from braying, with particular emphasis on the key role played by the otolaryngologist Arthur James Moffett in devoicing the mules of the second Chindit expedition of World War II. Methods: The PubMed database (1900-2017) and Google search engine were used to identify articles related to devoicing mules in the m...
Nerve Stimulator-guided Injection of Autologous Stem Cells Near the Equine Left Recurrent Laryngeal Nerve. Recurrent laryngeal neuropathy (RLN) commonly affects horses and is characterized by abnormal respiratory sounds and exercise intolerance. The recurrent laryngeal nerve shows lesions of demyelination. The benefit of applying stem cells to demyelinated nerves has been demonstrated in various animal models. The aim of the study was to test the feasibility and safety of a peri-neuronal injection of autologous muscle-derived mesenchymal stem cells to the left recurrent laryngeal nerve in healthy horses by using an electrical nerve stimulator. Muscle-derived stems cell are obtained from five health...
Anatomy of the vestibulum esophagi and surgical implications during prosthetic laryngoplasty in horses. 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...
Overground endoscopic findings and respiratory sound analysis in horses with recurrent laryngeal neuropathy after unilateral laser ventriculocordectomy. 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...
In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction. 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 ...
Using quarterly earnings to assess racing performance in 66 thoroughbreds after transendoscopic laser surgery for treatment of epiglottic entrapment. To assess the outcome of transendoscopic laser surgery for the treatment of epiglottic entrapment (EE) and determine the influence of preoperative morphological characteristics on outcomes. Methods: Retrospective cohort study. Methods: Thoroughbred racehorses treated with transendoscopic laser surgery (n = 66) and untreated cohorts (n = 132). Methods: Medical, surgical, and race records of 66 horses treated with transendoscopic laser surgery were compared with untreated cohorts randomly selected from their last race presurgery. Postsurgery data were collated as number of starts and rac...
Upper Airway Conditions Affecting the Equine Athlete. Many abnormalities of the upper airway that can inhibit performance are determined on a critical resting endoscopic evaluation. Some dynamic abnormalities can only be seen during an exercising endoscopic evaluation, which should be performed whenever the history of abnormal noise or performance limitations is not completely consistent with the resting endoscopic findings. Head and neck position may play a critical role in the evaluation process and the exact position during performance should be reproduced during the clinical examination to definitively define the abnormality. Treatments and p...
Comparison of morphological changes and tactile sensitivity of the pharynx and larynx between four standing sedative and analgesic protocols in eight adult healthy horses. To compare the topographic modifications and tactile sensitivity of the pharynx and larynx after administration of four sedative and analgesic protocols in standing horses. Methods: Experimental, observer-blinded, crossover study. Methods: Eight healthy mares. Methods: Five protocols were evaluated: 1) xylazine and butorphanol administered intravenously (IV); 2) detomidine and butorphanol administered IV; 3) xylazine administered IV and lidocaine topically; 4) detomidine administered IV and lidocaine topically and 5) no analgesia or sedation (control). Quality of sedation, head height and sudd...
The occurrence of dynamic structural disorders in the pharynx and larynx, at rest and during exercise, in horses diagnosed with mild and moderate Equine Asthma (Inflammatory Airway Disease). The goal of the present study was to establish the occurrence of structural disorders in the larynx and pharynx during treadmill exercise tests in horses diagnosed with Equine Asthma (EA). Investigation was performed in 29 horses, patients of the Equine Clinic of the Warsaw University of Life Sciences in Poland, admitted with poor exercise performance. Upper and lower airway examinations were performed in all patients revealing both mild to moderate Equine Asthma (13 horses), and no lower airway abnormalities (16 animals). In the group of horses with EA, 11 did not have structural disorders of...
Modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy in horses. In horses, the only established method for reinnervation of the larynx is the nerve-muscle pedicle implantation, whereas in human medicine, direct nerve implantation is a standard surgical technique for selective laryngeal reinnervation in human patients suffering from bilateral vocal fold paralysis. Objective: (1) To describe a modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses and (2) evaluate the outcomes of reinnervation using direct nerve needle-stimulation of the first cervical nerve and exercising endosco...
Hold your horses: A comparison of human laryngomalacia with analogous equine airway pathology. Laryngomalacia is the most common cause of stridor in infants. Dynamic airway collapse is also a well-recognised entity in horses and an important cause of surgical veterinary intervention. We compare the aetiology, clinical features and management of human laryngomalacia with equine dynamic airway collapse. Methods: A structured review of the PubMed, the Ovid Medline and the Cochrane Collaboration databases (Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews). Results: There are numerous equine conditions that cause dynamic airway collapse defined specifical...