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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.
[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 ...
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...
Examination of the upper and lower respiratory tract relevant to purchase. The intent and extent of the respiratory tract examination relevant to purchase are dictated by numerous factors, including historical information, signs suggestive of respiratory tract abnormalities, intended use of the horse, and economic considerations. Following a thorough and systematic examination of the horse at rest, evaluation during and following exercise may be warranted. The physical examination should include evaluation of regional symmetry of the head, neck, and thorax; evaluation of nasal airflow and patency; palpation of the nasal septum, larynx, and trachea; examination for su...
Respiratory stridor associated with polymyopathy suspected to be hyperkalemic periodic paralysis in four quarter horse foals. Four Quarter Horse foals ranging in age from 6 days to 2 months were determined to have upper airway stridor secondary to polymyopathy suspected to be hyperkalemic periodic paralysis. Electromyography revealed spontaneous muscle activity in all muscles examined. Electromyographic findings were similar in the dams of 3 foals (No. 1, 3 and 4). Hyperkalemia was found in foals 1 and 4. Endoscopically, the upper airway stridor in foals 1 and 3 was confirmed to be attributable to laryngeal and pharyngeal collapse or spasm. Foals 1, 2, and 3 were treated with acetazolamide. Foal 4 was not treated, at...
Horner’s syndrome in ten horses. Ten cases of equine Horner's syndrome were reviewed. None of the clinical signs in this series were transient (<48 hours). Sweating and ptosis were consistently observed by the attending clinician in over half of the affected horses. Enophthalmos and prolapse of the third eyelid were not reported consistently. The average duration of the clinical signs was 4.94 months and ranged from 14 days to 15 months. Eight of the ten horses developed associated complications, some of which affected performance. Airway obstruction and impedance of passage of a fiberoptic endoscope due to nasal mucosal e...
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...
Standing endoscopic electrosurgery. Common equine upper respiratory conditions are diagnosed via endoscopy. Endoscopic surgery facilitates correction of many conditions without general anesthesia or laryngotomy, reducing the morbidity and cost of the procedures. Modalities of endoscopic surgery include the Nd-YAG laser or electrosurgery, which may be complementary. The least expensive method is electrosurgery, and instruments are available that can be passed through the biopsy channel of the endoscope. Conditions amenable to such procedures include entrapped epiglottis, rostral displacement of the palatopharyngeal arch, pharynge...
Evaluation of epiglottic augmentation by use of polytetrafluoroethylene paste in horses. Epiglottic augmentation was evaluated in 7 horses, using 7 ml of polytetrafluoroethylene (polytef) paste injected submucosally on the ventral surface of the epiglottis. In 6 horses, an Arnold-Bruning intracordal injection syringe, specifically designed to inject polytef into paralyzed vocal folds in human beings, was used. At necropsy 60 days after surgery, group mean thickness measurement 20 mm from the epiglottic tip was 40% greater (P less than 0.01) and, at the epiglottic attachment of the aryepiglottic fold, was 29% greater (P less than 0.01) in the 6 polytef-augmented horses than in clin...
[The effect of the sedative and analgesic detomidine for laryngoscopy of adult horses and foals]. 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...
Soft palate hypoplasia in a horse. Several imaging techniques were used to diagnose hypoplasia of the soft palate in a horse. The absence of the caudal soft palate, hypertrophied lymphoid tissue and the formation of a pseudouvula were observed endoscopically. Plain and contrast radiography were used to demonstrate a soft palate remnant and to identify structures rostral to the epiglottis. Retrograde endoscopy of the pharynx via a tracheotomy incision is described.
The reliability of endoscopic examination in assessment of arytenoid cartilage movement in horses. Part II. Influence of side of examination, reexamination, and sedation. Twenty Thoroughbred and Standardbred horses underwent endoscopic evaluation of arytenoid cartilage movement twice within 1 week. Each time, a flexible endoscope was passed without sedation through the right nostril and the left nostril, and through the right nostril 5 minutes after administration of xylazine hydrochloride (0.55 mg/kg or 1.1 mg/kg intravenously). Laryngeal cartilage movement was videorecorded. All videotaped images were reviewed by three veterinarians and subjectively placed in one of four grades. The intraobserver agreement rate varied from 52.6% for examination under sedation...
Evaluation of peroral transendoscopic contact neodymium:yttrium aluminum garnet laser and snare excision of subepiglottic cysts in horses. Three basic techniques (and one modified technique) were developed, allowing successful excision of subepiglottic cysts in 10 horses (5 Standardbreds, 4 Thoroughbreds, and 1 Quarter Horse; mean age, 3.5 years) via peroral approach. This approach eliminated the need for laryngotomy or pharyngotomy and reduced postoperative care. None of the cysts redeveloped. Clinical signs of disease before surgery included respiratory noise, exercise intolerance, coughing, and dysphagia and were eliminated in all horses except one that raced successfully, but in which some respiratory noise was detected. Pero...
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...
Upper airway conditions in older horses, broodmares, and stallions. Upper respiratory tract conditions of the older horse that are not necessarily associated with athletic exercise intolerance are discussed. Some of the diseases described include ethmoid hematoma, sinus disease, guttural pouch empyema and mycosis, retropharyngeal abscess, nasopharyngeal cicatrix, arytenoid chondropathy, and neoplasia.
Upper respiratory obstruction in foals, weanlings, and yearlings. Upper airway obstruction may result from nasal, pharyngeal, or tracheal diseases. In the young horse, a relatively severe obstruction usually is present before clinical signs are evident. This article reviews the clinical manifestations, diagnostic features, treatment, and outcome of commonly encountered conditions of the nasal passages, pharynx, larynx, and trachea in young horses.
Upper airway obstruction in performance horses. Differential diagnoses and treatment. Abnormalities of the nasal cavity, pharynx, larynx, and trachea result in respiratory noise and exercise intolerance. Clinical features of common upper respiratory conditions of performance horses are reviewed with emphasis on diagnosis, treatment, and risk factors that affect the outcome of surgical treatment.
Application of lasers in equine upper respiratory surgery. 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.
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.
Preferential denervation of the adductor muscles of the equine larynx. I: Muscle pathology. The laryngeal muscles of 18 horses were examined histologically. The neurogenic changes found in each muscle were scored by four reviewers and the results evaluated statistically. Fifteen of these horses had endoscopic evidence of abnormal laryngeal function, three of which were defined as having adductor paralysis. Measurement of muscle fibre area in two horses with idiopathic laryngeal hemiplegia (ILH) was performed. In the quantitative study of neurogenic change, the adductor muscles were more significantly affected than the abductor muscle. This was also true in the clinical cases of ILH w...
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...
Correlation of performance with endoscopic and radiographic assessment of epiglottic hypoplasia in racehorses with epiglottic entrapment corrected by use of contact neodymium:yttrium aluminum garnet laser. Epiglottic entrapment in 35 Thoroughbred and 44 Standardbred horses was corrected transendoscopically by use of a neodymium:yttrium aluminum garnet laser. Before surgery, the entrapped epiglottis was classified as hypoplastic or normal in each horse on the basis of endoscopic appearance alone. Using a digitizer, thyroepiglottic length was determined from lateral-view laryngeal radiographs. For 78 racehorses, earnings (less than $5,000 or greater than $5,000) were compared before and after surgery. Earnings category and racing performance after surgery were tested for association with endoscopi...
Use of the forced oscillating airflow technique to measure the resistance of the equine upper airway: effects of laryngoventriculectomy and laryngoplasty. Investigations were carried out to determine whether measurements of total respiratory resistance (TRR) made in resting animals could detect changes due to laryngeal hemiplegia. Control values of TRR were obtained in eight ponies and in six of these the measurements were repeated after division of the left recurrent laryngeal nerve in the mid-cervical region; two were retained as controls. A further set of measurements were made before two of the operated animals were subjected to left laryngoventriculectomy (Hobday operation). A laryngoplasty ('tie-back' operation) was performed on another tw...
Arytenoidectomy for advanced unilateral chondropathy with accompanying lesions. A noncurrent prospective study of nonworking horses with arytenoid chondropathy was conducted to confirm a clinical impression that horses with unilateral chondropathy and accompanying lesions had a poorer prognosis after arytenoidectomy than horses with bilateral or uncomplicated unilateral chondropathy. Surgical failure was defined as death, euthanasia, permanent tracheostomy, or reoperation. Survival to surgical failure and clinical improvement data were compared between horses with and without accompanying lesions treated by arytenoidectomy. The probability of surgical failure was signific...
Transendoscopic contact neodymium:yttrium aluminum garnet laser correction of epiglottic entrapment in standing horses. Fifty-seven Standardbred and 44 Thoroughbred racehorses and 1 Thoroughbred polo mare with primary clinical signs of exercise intolerance or respiratory tract noise or combined exercise intolerance and respiratory tract noise were referred for laser correction of epiglottic entrapment. Significantly (P less than 0.001) more Standardbred than Thoroughbred racehorses were affected, compared with the observed hospital population during the same period. At referral, 14 horses did not have evident epiglottic entrapment and were returned to exercise without development of entrapment after treatment, ...
Epiglottic augmentation in the horse. Epiglottic augmentation with injectable bovine collagen or an autogenous or allogenous auricular cartilage graft was performed in 12 horses with endoscopically and radiographically normal epiglottises. The grafting procedures were easy to perform and did not cause apparent discomfort. Cartilage graft extrusion or resorption may have occurred, but was not seen by endoscopy and lateral laryngeal radiography. Only collagen implants remained evident endoscopically, as smooth round submucosal bulges ventral to the epiglottic cartilage. Two horses with collagen implants, and all horses with cartilag...
Surgery of the upper respiratory tract in the racehorse. The authors discuss the surgical treatment of selected diseases of the upper airway of the racehorse. Although most of these conditions occur commonly and are easily diagnosed, their surgical management is often less straight-forward and may be surprisingly controversial. The authors' intent is to provide an overview of these problems and give some information regarding current treatment options.
Anatomy of the laryngeal and adjacent regions as perceived by palpation of clinically normal standing horses. The anatomy of each feature and structure of the laryngeal and adjacent regions, as perceived by palpation, is described for clinically normal standing horses. Visible skin contours produced by some of the superficial structures are also described. Concurrent dissection was performed on fresh cadavers to confirm initial findings. The procedure of systematic palpation in relation to clinical diagnosis and surgical procedure is discussed.
