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Veterinary surgery : VS2024; doi: 10.1111/vsu.14115

Enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty using 3-D-printed laryngeal clamps: An ex vivo model study.

Abstract: 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, and construct failure. Finite element analysis (FEA) was performed on one PL and one PLLC construct. Results: The maximum load at single tension to failure was 183.7 ± 46.8 N for the PL construct and 292.7 ± 82.3 N for the PLLC construct (p = .003). Actuator displacement at 30 N was 1.7 ± 0.5 mm and 2.7 ± 0.7 mm for the PL and PLLC constructs, respectively (p = .011). The cause of PL constructs failure was mostly tearing through the cartilage whereas the PLLC constructs failed through fracture of the cricoid cartilage (p = .000). FEA revealed an 11-fold reduction in the maximum equivalent plastic strain, a four-fold reduction in maximum compressive stress, and a two-fold increase in the volume of engaged cartilage in PLLC constructs. Conclusions: The PLLC constructs demonstrated superior performance in biomechanical testing and FEA compared to standard PL constructs. Conclusions: The use of 3-D-printed laryngeal clamps may enhance the outcomes of laryngoplasty in horses. In vivo studies are necessary to determine the feasibility of performing laryngoplasty using the laryngeal clamp in horses.
© 2024 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2024-06-05 PubMed ID: 38840447DOI: 10.1111/vsu.14115Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research focuses on examining the effectiveness of a 3-D printed laryngeal clamp (LC) in enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty. The results suggest that the implementation of this 3-D printed laryngeal clamp during a laryngoplasty procedure in horses may result in improved outcomes.

Introduction and Objectives

  • The study was conducted with the aim of evaluating a three-dimensional (3-D)-printed laryngeal clamp (LC), a novel tool designed to improve the anchoring of laryngeal prostheses at the cricoid cartilage in horses.
  • The effectiveness of this tool was assessed in enhancing the stability of prostheses in equine laryngoplasty, a surgical procedure used to treat airway obstruction in horses.

Materials and Methods

  • An ex vivo biomechanical study was carried out on 22 equine larynges.
  • The larynges were divided into two groups: those with standard prosthetic laryngoplasty (PL; n = 10) and larynges on which prosthetic laryngoplasty was performed with the aid of laryngeal clamps (PLLC; n = 10).
  • Biomechanical parameters including maximum load, actuator displacement, and construct failure were recorded after subjecting constructs to 3000 cycles of tension loading and a single tension to failure.
  • Finite element analysis (FEA) was performed on one PL and one PLLC construct for an in-depth assessment of the localized forces, stress, and strain within the constructs.

Results

  • The PLLC constructs demonstrated better performance under failure tension, showing an increased maximum load compared to the PL constructs.
  • The actuator displacement, or the lateral movement of the implants, was also notably higher in the PLLC constructs.
  • Failure modes of the constructs differed, with the PL constructs mainly failing through tearing of the cartilage, while the PLLC constructs failed via fracture of the cricoid cartilage.
  • The FEA revealed significant reductions in maximum equivalent plastic strain and maximum compressive stress, alongside an increase in the volume of engaged cartilage, in the PLLC constructs as opposed to the PL constructs.

Conclusions

  • The results confirm that the 3-D printed laryngeal clamps proved to enhance the biomechanical performance of the laryngeal prostheses in ex vivo equine laryngoplasty models.
  • These findings suggest that the use of these clamps in laryngoplasty procedures could potentially improve surgical outcomes in horses.
  • The researchers recommend conducting in vivo studies to further validate the feasibility and effectiveness of performing laryngoplasty using the laryngeal clamp in horses.

Cite This Article

APA
Grzeskowiak R, Schumacher J, Omidi O, Bowers K, Cassone LMC, Abedi R, Hespel AM, Mulon PY, Anderson DE. (2024). Enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty using 3-D-printed laryngeal clamps: An ex vivo model study. Vet Surg. https://doi.org/10.1111/vsu.14115

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Grzeskowiak, Remigiusz
  • College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.
Schumacher, Jim
  • College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.
Omidi, Omid
  • Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA.
Bowers, Kristin
  • College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.
Cassone, Lynne M C
  • College of Agriculture, Food and Environment, Veterinary Diagnostic Laboratory, The University of Kentucky, Lexington, Kentucky, USA.
Abedi, Reza
  • Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA.
Hespel, Adrien-Maxence
  • College of Veterinary Medicine, Small Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.
Mulon, Pierre-Yves
  • College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.
Anderson, David E
  • College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA.

References

This article includes 58 references
  1. Brakenhoff JE, Holcombe SJ, Hauptman JG, Smith HK, Nickels FA, Caron JP. The prevalence of laryngeal disease in a large population of competition draft horses.. Vet Surg 2006;35(6):579‐583.
    doi: 10.1111/j.1532‐950x.2006.00192.xgoogle scholar: lookup
  2. Dixon PM, McGorum BC, Railton DI. Laryngeal paralysis: a study of 375 cases in a mixed‐breed population of horses.. Equine Vet J 2001;33(5):452‐458.
    doi: 10.2746/042516401776254790google scholar: lookup
  3. Davison JA, Lumsden JM, Boston RC, Ahern BJ. Overground endoscopy in 311 thoroughbred racehorses: findings and correlation to resting laryngeal function.. Aust Vet J 2017;95(9):338‐342.
    doi: 10.1111/avj.12620google scholar: lookup
  4. Lane JG, Bladon B, Little DR, Naylor JR, Franklin SH. Dynamic obstructions of the equine upper respiratory tract. Part 1: observations during high‐speed treadmill endoscopy of 600 thoroughbred racehorses.. Equine Vet J 2006;38(5):393‐399.
    doi: 10.2746/042516406778400583google scholar: lookup
  5. Allen KJ, Franklin SH. Comparisons of overground endoscopy and treadmill endoscopy in UK thoroughbred racehorses.. Equine Vet J 2010;42(3):186‐191.
    doi: 10.1111/j.2042‐3306.2010.00033.xgoogle scholar: lookup
  6. Marks D, Mackay‐Smith MP, Cushing LS, Leslie JA. Use of a prosthetic device for surgical correction of laryngeal hemiplegia in horses.. J Am Vet Med Assoc 1970;157(2):157‐163.
  7. Kidd JA, Slone DE. Treatment of laryngeal hemiplegia in horses by prosthetic laryngoplasty, ventriculectomy and vocal cordectomy.. Vet Rec 2002;150(15):481‐484.
    doi: 10.1136/vr.150.15.481google scholar: lookup
  8. Davenport CL, Tulleners EP, Parente EJ. The effect of recurrent laryngeal neurectomy in conjunction with laryngoplasty and unilateral ventriculocordectomy in thoroughbred racehorses.. Vet Surg 2001;30(5):417‐421.
    doi: 10.1053/jvet.2001.25865google scholar: lookup
  9. Witte TH, Mohammed HO, Radcliffe CH, Hackett RP, Ducharme NG. Racing performance after combined prosthetic laryngoplasty and ipsilateral ventriculocordectomy or partial arytenoidectomy: 135 thoroughbred racehorses competing at less than 2400 m (1997–2007).. Equine Vet J 2009;41(1):70‐75.
    doi: 10.2746/042516408x343163google scholar: lookup
  10. Leutton JL, Lumsden JM. Dynamic respiratory endoscopic findings pre‐ and post‐laryngoplasty in thoroughbred racehorses.. Equine Vet J 2015;47(5):531‐536.
    doi: 10.1111/evj.12331google scholar: lookup
  11. Dixon RM, McGorum BC, Railton DI. Long‐term survey of laryngoplasty and ventriculocordectomy in an older, mixed‐breed population of 200 horses. Part 1: maintenance of surgical arytenoid abduction and complications of surgery.. Equine Vet J 2003;35(4):389‐396.
    doi: 10.2746/042516403776014172google scholar: lookup
  12. Brown JA, Derksen FJ, Stick JA, Hartmann WM, Robinson NE. Effect of laryngoplasty on respiratory noise reduction in horses with laryngeal hemiplegia.. Equine Vet J 2004;36(5):420‐425.
    doi: 10.2746/0425164044868440google scholar: lookup
  13. Barakzai SZ, Boden LA, Dixon PM. Race performance after laryngoplasty and ventriculocordectomy in National Hunt racehorses.. Vet Surg 2009;38(8):941‐945.
    doi: 10.1111/j.1532‐950x.2009.00600.xgoogle scholar: lookup
  14. Davidson EJ, Martin BB, Rieger RH, Parente EJ. Exercising videoendoscopic evaluation of 45 horses with respiratory noise and/or poor performance after laryngoplasty.. Vet Surg 2010;39(8):942‐948.
    doi: 10.1111/j.1532‐950x.2010.00746.xgoogle scholar: lookup
  15. Barnett TP, O'Leary JM, Parkin TD, Dixon PM, Barakzai SZ. Long‐term maintenance of arytenoid cartilage abduction and stability during exercise after laryngoplasty in 33 horses.. Vet Surg 2013;42(3):291‐295.
    doi: 10.1111/j.1532‐950x.2013.01109.xgoogle scholar: lookup
  16. Ahern BJ, Boston RC, Parente EJ. In vitro mechanical testing of an alternate laryngoplasty system (ALPS) for horses.. Vet Surg 2012;41(8):918‐923.
    doi: 10.1111/j.1532‐950x.2012.01061.xgoogle scholar: lookup
  17. Dean PW, Nelson JK, Schumacher J. Effects of age and prosthesis material on in vitro cartilage retention of laryngoplasty prostheses in horses.. Am J Vet Res 1990;51(1):114‐117.
  18. Dahlberg JA, Valdes‐Martinez A, Boston RC, Parente EJ. Analysis of conformational variations of the cricoid cartilages in thoroughbred horses using computed tomography.. Equine Vet J 2011;43(2):229‐234.
    doi: 10.1111/j.2042‐3306.2010.00070.xgoogle scholar: lookup
  19. Froydenlund TJ, Dixon PM. A review of equine laryngoplasty complications.. Equine Vet Educ 2014;26:98‐106.
  20. Kelly JR, Carmalt J, Hendrick S, Wilson DG, Shoemaker R. Biomechanical comparison of six suture configurations using a large diameter polyester prosthesis in the muscular process of the equine arytenoid cartilage.. Vet Surg 2008;37(6):580‐587.
    doi: 10.1111/j.1532‐950x.2008.00423.xgoogle scholar: lookup
  21. Herde I, Boening KJ. Arytenoid cartilage retention of laryngoplasty in horses—in vitro assessment of effect of age, placement site and implantation technique.. Proc Am Assoc Equine Pract 2001;47:115‐119.
  22. Ahern BJ, Parente EJ. Mechanical evaluation of the equine laryngoplasty.. Vet Surg 2010;39(6):661‐666.
    doi: 10.1111/j.1532‐950x.2010.00701.xgoogle scholar: lookup
  23. Ahern BJ, Lim YW, van Eps A, Franklin S. In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction.. Vet Surg 2018;47(6):837‐842.
    doi: 10.1111/vsu.12933google scholar: lookup
  24. Ahern BJ, Lukas E, Lam K. Evaluation of a prototype dynamic laryngoplasty system in vitro with an equine vacuum airflow system.. Vet Surg 2019;48(2):173‐179.
    doi: 10.1111/vsu.13137google scholar: lookup
  25. Secor EJ, Gutierrez‐Nibeyro SD, Horn GP. Biomechanical evaluation of modified laryngoplasty by use of a toggle technique for stabilization of arytenoid cartilage in specimens obtained from equine cadavers.. Am J Vet Res 2018;79(2):226‐232.
    doi: 10.2460/ajvr.79.2.226google scholar: lookup
  26. Willsallen H, Heller J, Kark L, Hilbert BJ. In vitro mechanical testing of braided polyurethane elastic fiber and braided polyester for equine laryngoplasty.. Vet Surg 2015;44(2):223‐230.
    doi: 10.1111/j.1532‐950x.2014.12184.xgoogle scholar: lookup
  27. Brandenberger O, Rossignol F, Perkins JD. Ex vivo biomechanical stability of 5 cricoid‐suture constructs for equine laryngoplasty.. Vet Surg 2017;46(5):705‐713.
    doi: 10.1111/vsu.12671google scholar: lookup
  28. Ahern BJ, Van Eps AW, Boston RC, Franklin SH. In vitro comparison of 3 techniques of prosthesis attachment to the muscular process of the equine arytenoid cartilage.. Vet Surg 2017;46(5):700‐704.
    doi: 10.1111/vsu.12659google scholar: lookup
  29. Schumacher J, Wilson AM, Pardoe C, Easter JL. In vitro evaluation of a novel prosthesis for laryngoplasty of horses with recurrent laryngeal neuropathy.. Equine Vet J 2000;32(1):43‐46.
    doi: 10.2746/042516400777611991google scholar: lookup
  30. Lechartier A, Rossignol F, Brandenberger O. Mechanical comparison of 3 anchoring techniques in the muscular process for laryngoplasty in the equine larynx.. Vet Surg 2015;44(3):333‐340.
    doi: 10.1111/j.1532‐950x.2014.12248.xgoogle scholar: lookup
  31. Scherzer S, Hainisch EK. Evaluation of a canine cranial cruciate ligament repair system for use in equine laryngoplasty.. Vet Surg 2005;34(6):548‐553.
    doi: 10.1111/j.1532‐950x.2005.00086.xgoogle scholar: lookup
  32. Grzeskowiak RM, Schumacher J, Dhar MS, Harper DP, Mulon PY, Anderson DE. Bone and cartilage interfaces with orthopedic implants: a literature review.. Front Surg 2020;7:601244.
    doi: 10.3389/fsurg.2020.601244pmc: PMC7779634google scholar: lookup
  33. Wong JK, Cerovac S, Ferguson MW, McGrouther DA. The cellular effect of a single interrupted suture on tendon.. J Hand Surg Br 2006;31(4):358‐367.
  34. Rawson S, Cartmell S, Wong J. Suture techniques for tendon repair; a comparative review.. Muscles, Ligaments Tendons J 2013;220(3):220‐228.
  35. Wong JK, Alyouha S, Kadler KE, Ferguson MW, Mc‐Grouther DA. The cell biology of suturing tendons.. Matrix Biol 2010;29(6):525‐536.
  36. Redman SN, Dowthwaite GP, Thomson BM, Archer CW. The cellular responses of articular cartilage to sharp and blunt trauma.. Osteoarthr Cartil 2004;12:106‐116.
  37. Tew SR, Kwan AP, Hann A, Thomson BM, Archer CW. The reactions of articular cartilage to experimental wounding: role of apoptosis.. Arthritis Rheum 2000;43:215‐225.
  38. Savage AJ, Spruiell MD, Schwertz JM, McGwin G, Eberhardt A, Ponce BA. The effect of sliding knots on the suture‐tendon Interface strength.. Am J Sports Med 2013;41(2):296‐301.
  39. Ponce BA, Hosemann CD, Raghava P, Tate JP, Sheppard ED, Eberhardt AW. A biomechanical analysis of controllable intraoperative variables affecting the strength of rotator cuff repairs at the suture‐tendon interface.. Am J Sports Med 2013;41(10):2256‐2261.
    doi: 10.1177/0363546513499228google scholar: lookup
  40. Midha S, Dalela M, Sybil D, Patra P, Mohanty S. Advances in three‐dimensional bioprinting of bone: Progress and challenges.. J Tissue Eng Regen Med 2019;13(6):925‐945.
    doi: 10.1002/term.2847google scholar: lookup
  41. Grzeskowiak RM, Schumacher J, Mulon PY, Steiner RC, Cassone L, Anderson DE. Ex‐vivo mechanical testing of novel LCs used for laryngeal advancement constructs.. Front Vet Sci 2020;12(7):139.
    doi: 10.3389/fvets.2020.00139pmc: PMC7081719google scholar: lookup
  42. Chan RW, Titze IR. Effect of postmortem changes and freezing on the viscoelastic properties of vocal fold tissues.. Ann Biomed Eng 2003;31(4):482‐491.
    doi: 10.1114/1.1561287google scholar: lookup
  43. Changoor A, Fereydoonzad L, Yaroshinsky A, Buschmann MD. Effects of refrigeration and freezing on the electromechanical and biomechanical properties of articular cartilage.. J Biomech Eng 2010;132(6):064502.
    doi: 10.1115/1.4000991google scholar: lookup
  44. Passman SN, Cheetham J, Bonassar LJ, Ducharme NG, Rawlinson JJ. Biomechanical characterization of equine laryngeal cartilage.. Equine Vet J 2011;43(5):592‐598.
    doi: 10.1111/j.2042‐3306.2010.00315.xgoogle scholar: lookup
  45. Behrens E, Poteet B, Cohen N. Equine cricoid cartilage densitometry.. Can J Vet Res 1993;57(4):307‐308.
    pmc: PMC1263646
  46. Witte TH, Cheetham J, Soderholm LV, Mitchell LM, Ducharme NG. Equine laryngoplasty sutures undergo increased loading during coughing and swallowing.. Vet Surg 2010;39(8):949‐956.
    doi: 10.1111/j.1532‐950x.2010.00742.xgoogle scholar: lookup
  47. Smith G, Markel M, Roe S, Budsberg S. Biomechanics for Surgeons.. ACVS Symposium 1993.
  48. Santos MP, Gutierrez‐Nibeyro SD, Horn GP, Johnson AJ, Stewart MC, Schaeffer DJ. Mechanical properties of various suture materials and placement patterns tested with surrogate in vitro model constructs simulating laryngeal advancement tie‐forward procedures in horses.. Am J Vet Res 2014;75(5):500‐506.
    doi: 10.2460/ajvr.75.5.500google scholar: lookup
  49. Li Y, Ortiz C, Boyce MC. A generalized mechanical model for suture interfaces of arbitrary geometry.. J Mech Phys Solids 2013;61(4):1144‐1167.
  50. Wuest DM, Meyer DC, Favre P, Gerber C. Mechanical and handling properties of braided polyblend polyethylene sutures in comparison to braided polyester and monofilament polydioxanone sutures.. Art Ther 2006;22(11):1146‐1153.
    doi: 10.1016/j.arthro.2006.06.013google scholar: lookup
  51. Singhvi MS, Zinjarde SS, Gokhale DV. Polylactic acid: synthesis and biomedical applications.. J Appl Microbiol 2019;127(6):1612‐1626.
    doi: 10.1111/jam.14290google scholar: lookup
  52. Haers PE, Suuronen R, Lindqvist C, Sailer H. Biodegradable polylactide plates and screws in orthognathic surgery: technical note.. J Craniomaxillofac Surg 1998;26(2):87‐91.
    doi: 10.1016/s1010‐5182(98)80045‐0google scholar: lookup
  53. Pang X, Zhuang X, Tang Z, Chen X. Polylactic acid (PLA): research, development and industrialization.. Biotechnol J 2010;5(11):1125‐1136.
    doi: 10.1002/biot.201000135google scholar: lookup
  54. Tsuji H. Poly(lactide) stereocomplexes: formation, structure, properties, degradation, and applications.. Macromol Biosci 2005;5(7):569‐597.
    doi: 10.1002/mabi.200500062google scholar: lookup
  55. Ramot Y, Haim‐Zada M, Domb AJ, Nyska A. Biocompatibility and safety of PLA and its copolymers.. Adv Drug Deliv Rev 2016;107:153‐162.
    doi: 10.1016/j.addr.2016.03.012google scholar: lookup
  56. Nyberg E, Rindone A, Dorafshar A, Grayson WL. Comparison of 3D‐printed poly‐ɛ‐caprolactone scaffolds functionalized with tricalcium phosphate, hydroxyapatite, bio‐Oss, or decellularized bone matrix.. Tissue Eng Part A 2017;23(11–12):503‐514.
    doi: 10.1089/ten.tea.2016.0418google scholar: lookup
  57. Ma Z, Gao C, Gong Y, Shen J. Cartilage tissue engineering PLLA scaffold with surface immobilized collagen and basic fibroblast growth factor.. Biomaterials 2005;26(11):1253‐1259.
    doi: 10.1016/j.biomaterials.2004.04.031google scholar: lookup
  58. Mania S, Partyka K, Pilch J. Obtaining and characterization of the PLA/chitosan foams with antimicrobial properties achieved by the emulsification combined with the dissolution of chitosan by CO2 saturation.. Molecules 2019;24(24):4532.
    doi: 10.3390/molecules24244532pmc: PMC6943705google scholar: lookup

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