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Veterinary surgery : VS2024; 53(7); 1185-1195; doi: 10.1111/vsu.14108

Equine laryngoplasty: Effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage.

Abstract: To compare the effects of three anchoring techniques in the muscular process and three positions of laryngoplasty suture implantation in the cricoid cartilage on abduction of the arytenoid cartilage and interaction with the cricoarytenoid dorsalis (CAD) muscle compartments. Methods: Experimental study. Methods: Twenty-two cadaveric equine larynges. Methods: Three implantation techniques were assessed in the left muscular process. They were the use of a titanium corkscrew (CS), a standard caudal passage using a Jamshidi needle (JCa), and a standard cranial passage using a Jamshidi needle (JCr). Each was assessed in combination with three caudal locations in the cricoid cartilage (right, left, and left lateral). Each suture combination was tightened to submaximal abduction (Dixon grade 2). Force on the suture, degree of larynx caudal rotation, and CAD muscle indentation were evaluated. Results: The force required for optimal arytenoid cartilage abduction was lower (p < .01) for constructs involving a CS (7.45 ± 4 N). The CS also resulted in lower (p < .01) CAD muscle indentation (2.01 ± 1.25 mm) and less larynx rotation (9 ± 3.87°; adjusted p < .05). Conclusions: When inserted into the muscular process at the CAD tendon insertion point, the biomechanical properties of the CS reduced the force required for optimal arytenoid cartilage abduction. The CS also minimized interference with the CAD muscle compartments and reduced caudal displacement of the left arytenoid cartilage when it was under suture tension. Conclusions: The CS implantation avoided larynx deformation and muscle interaction, offering the possibility to combine a nerve graft and laryngoplasty as a treatment for recurrent laryngeal neuropathy.
© 2024 American College of Veterinary Surgeons.
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Publication Date: 2024-05-24 PubMed ID: 38787348DOI: 10.1111/vsu.14108Google Scholar: Lookup
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  • Journal Article

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.

Overview

  • This study evaluated three different surgical anchoring techniques and three suture positions used in equine laryngoplasty, a procedure to improve airway function in horses.
  • The research assessed which combination provides optimal arytenoid cartilage movement with the least force and minimal interference with the associated muscles, potentially improving treatment outcomes for laryngeal neuropathy in horses.

Background and Purpose

  • Equine laryngoplasty is a surgical procedure performed to correct recurrent laryngeal neuropathy—a condition causing partial paralysis of the horse’s vocal cord (arytenoid cartilage), leading to airway obstruction and poor exercise performance.
  • The procedure involves placing sutures to abduct (move open) the arytenoid cartilage via anchoring techniques in the muscular process of the arytenoid and implanting sutures on the cricoid cartilage.
  • The study aimed to compare three anchoring techniques at the arytenoid’s muscular process and three suture positions on the cricoid cartilage to determine their effect on cartilage abduction, force required, and interaction with the cricoarytenoid dorsalis (CAD) muscle.
  • Researchers wanted to find which technique provides effective cartilage opening with minimal muscle interference and tissue deformation.

Methods

  • Used 22 cadaveric equine larynges to perform controlled tests.
  • Three anchoring techniques were tested on the left muscular process:
    • Titanium corkscrew (CS) implanted at the CAD tendon insertion point.
    • Standard caudal passage using a Jamshidi needle (JCa).
    • Standard cranial passage using a Jamshidi needle (JCr).
  • The three suture implantation positions on the cricoid cartilage were:
    • Right position
    • Left position
    • Left lateral position
  • Each combination of anchoring technique and suture position was adjusted to achieve a consistent, submaximal arytenoid abduction (Dixon grade 2, defined by previous clinical standards).
  • Evaluations included:
    • Force required on the suture to achieve the abduction
    • Degree of caudal rotation (backward rotation) of the larynx under tension
    • Indentation on the CAD muscle caused by the suture, indicating muscle interference

Results

  • The titanium corkscrew (CS) anchoring technique required significantly less force (7.45 ± 4 N) than the standard Jamshidi needle techniques to achieve the same degree of arytenoid abduction (p < .01), indicating better mechanical efficiency.
  • The CS technique caused significantly less indentation of the CAD muscle (2.01 ± 1.25 mm) than the other methods, suggesting reduced interference or compression of the muscle (p < .01).
  • Laryngeal rotation caused by suture tension was also significantly less with the CS method (9 ± 3.87 degrees), meaning the larynx maintained a more natural alignment compared to other techniques (adjusted p < .05).

Conclusions and Clinical Implications

  • Implanting the titanium corkscrew at the muscular process’s CAD tendon insertion offers biomechanical advantages by:
    • Reducing the force needed to abduct the arytenoid cartilage effectively
    • Minimizing deformation and rotation of the larynx when under tension
    • Decreasing interference with the CAD muscle compartments, likely preserving muscle function
  • This technique could improve surgical outcomes for horses with recurrent laryngeal neuropathy by providing a more stable and less disruptive mechanical environment for arytenoid abduction.
  • Because it minimizes disruption to the muscle and laryngeal structure, the CS approach may enable combined treatments, such as performing nerve grafts alongside laryngoplasty, which could further enhance recovery and function.

Cite This Article

APA
Maire U, Ducharme NG, Rossignol A, Campos Schweitzer A, Rossignol F. (2024). Equine laryngoplasty: Effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage. Vet Surg, 53(7), 1185-1195. https://doi.org/10.1111/vsu.14108

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 53
Issue: 7
Pages: 1185-1195

Researcher Affiliations

Maire, Ulrika
  • Grosbois Equine Clinic, Paris, France.
Ducharme, Norm G
  • College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Rossignol, Anthony
  • Grosbois Equine Clinic, Paris, France.
Campos Schweitzer, Ariane
  • Grosbois Equine Clinic, Paris, France.
Rossignol, Fabrice
  • Grosbois Equine Clinic, Paris, France.

MeSH Terms

  • Animals
  • Horses / surgery
  • Horses / physiology
  • Laryngoplasty / veterinary
  • Laryngoplasty / methods
  • Cricoid Cartilage / surgery
  • Suture Techniques / veterinary
  • Cadaver
  • Arytenoid Cartilage / surgery
  • Laryngeal Muscles / surgery
  • Laryngeal Muscles / innervation

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Citations

This article has been cited 1 times.
  1. Ysebaert MP, Johnson J, Marie U, Campos A, Verchrerin A, Ducharme NG, Rossignol F, Luedke LK. Biomechanical testing of three constructs for prosthetic laryngoplasty in horses demonstrates advantages of differing metallic implants in the arytenoid cartilage.. Vet Surg 2026 Jan;55(1):69-77.
    doi: 10.1111/vsu.14328pubmed: 40785216google scholar: lookup
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