Aryepiglottic fold augmentation as treatment for late-onset dysphagia following surgical treatment of recurrent laryngeal neuropathy.

The research investigates a condition in horses known as late-onset dysphagia (difficulty swallowing) and coughing that occurs months to years after a surgery for recurrent laryngeal neuropathy. The authors observed that this condition was associated with an abnormal aryepiglottic fold (AEF), a part of the larynx. Treating this condition by augmenting the AEF with injections of different substances proved to be a successful method.

Objective of the Study

• The study had two main objectives. Firstly, it aimed to describe a new condition of late-onset dysphagia in horses after surgical procedure for the treatment of recurrent laryngeal neuropathy. The condition was identified to be associated with the abnormal appearance of the aryepiglottic fold (AEF), which is part of the larynx.
• Secondly, the research sought to offer a minimally invasive and successful treatment for these patients.

Methods Used in the Study

• The study involved six horses suffering from dysphagia and coughing, months to years after the surgery. They observed that the horses had a thinner and more flaccid AEF through endoscopy.
• The researchers traced the path of food along the AEF into the trachea using dyed molasses, a thick sweet syrup.
• An initial injection of hyaluronic acid (HA), a substance that helps in tissue repair, into the AEF led to immediate improvement of the dysphagia. This procedure was conducted while the horse was standing and under sedation. The injection was administered via the cricothyroid ligament under endoscopic guidance.

Results of the Study

• All the horses in the study tolerated the injections well.
• The writers observed that while initially successful, HA injections provided only short term relief, necessitating repeated injections for permanent resolution.
• The researchers also tried other substances for injections, including cross-linked HA, polyacrylamide hydrogel, or platelet rich plasma.

Conclusions Drawn from the Study

• This research concluded that horses may develop dysphagia and coughing months to years after certain surgical treatments, a symptom that appears to relate to an abnormal AEF.
• It also suggested that this condition can be successfully treated by augmenting the AEF using the previously mentioned substances.
• However, the research also pointed out that careful patient selection is crucial in order to ensure successful treatment outcomes.