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Veterinary surgery : VS2021; 50(7); 1409-1417; doi: 10.1111/vsu.13690

Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model.

Abstract: To evaluate the airway mechanics of modified toggle LP constructs in an airflow chamber model and compare these to the airway mechanics of standard LP constructs. Methods: Ex-vivo experimental study. Methods: Fifty-one equine cadaveric larynges. Methods: Bilateral LP constructs were performed using a modified toggle (n = 23) or a standard (n = 21) LP technique. Constructs were tested in an airflow model before and after cyclic loading which was designed to mimic postoperative swallowing. The cross-sectional area (CSA), peak translaryngeal airflow (L/s), and impedance (cmH 0/L/s) were determined and compared between LP constructs before and after cycling. Results: The mean CSA of the rima glottidis of the modified toggle LP constructs was 15.2 ± 2.6 cm before and 14.7 ± 2.6 cm after cyclic loading, and the mean CSA of the rima glottidis of the standard LP constructs was 16.4 ± 2.9 cm before and 15.7 ± 2.8 cm after cyclic loading. The modified toggle LP constructs had similar peak translaryngeal impedance before and after cyclic loading (p = .13); however, the standard LP constructs had higher peak translaryngeal impedance after cyclic loading (p = .02). Conclusions: The modified toggle and standard LP constructs had comparable airway mechanics in an ex-vivo model. Conclusions: Further investigation is warranted to determine the extent to which the modified toggle LP technique restores normal airway function in horses with RLN.
© 2021 American College of Veterinary Surgeons.
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Publication Date: 2021-07-26 PubMed ID: 34309058DOI: 10.1111/vsu.13690Google 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.

The research article assesses the air flow dynamics of two types of surgical procedures done on horse larynxes and compares their effect on the airway before and after simulated swallowing motions.

Research Method

  • The study used 51 larynges from horse cadavers for project, illustrating an ex-vivo experimental technique.
  • Two kinds of procedures were conducted on these larynges, referred to as a modified toggle (23 cases) and a standard (21 cases) LP (Laryngoplasty) technique.
  • Afterward, the constructs resulting from operations were subjected to an airflow model testing before and after a procedure designed to replicate the stress placed on the area through the process of swallowing. This process is termed as cyclic loading.

Measurements Taken

  • The cross-sectional area (CSA) of the rima glottidis (space between the vocal cords), peak translaryngeal airflow (the highest amount of airflow going through the larynx) and impedance (resistance to airflow through the larynx) were the three parameters considered for comparison purposes.
  • To compare how both the modified toggle and standard procedures affected the larynges, these parameters were evaluated both before and after cyclic loading.

Results

  • The CSA decrease was minor for both methods post cyclic loading. Associations between the CSA and airway obstruction were drawn.
  • The study discovered that standard LP constructs had increased peak translaryngeal impedance after cyclic loading.
  • Contrarily, the impedance for the modified LP constructs didn’t show a significant difference before and after cyclic loading, proving them to be more stable.

Conclusion

  • Despite the minor differences in changes post cyclic loading, the airway mechanics for both the procedures in the ex-vivo model were found to be similar.
  • However, the authors suggest more studies to fully understand the impact of these procedures on restoring regular airway function in horses with RLN (Recurrent Laryngeal Neuropathy), a common disease in horses affecting their vocal cords and leading to breathing difficulties.

Cite This Article

APA
Gray SM, Gutierrez-Nibeyro SD, Couëtil LL, Horn GP, Kesler RM, McCoy AM, Stewart MC, Schaeffer DJ. (2021). Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model. Vet Surg, 50(7), 1409-1417. https://doi.org/10.1111/vsu.13690

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 50
Issue: 7
Pages: 1409-1417

Researcher Affiliations

Gray, Sarah M
  • Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA.
Gutierrez-Nibeyro, Santiago D
  • Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA.
Couëtil, Laurent L
  • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA.
Horn, Gavin P
  • Illinois Fire Service Institute, University of Illinois, Champaign, Illinois, USA.
Kesler, Richard M
  • Illinois Fire Service Institute, University of Illinois, Champaign, Illinois, USA.
McCoy, Annette M
  • Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA.
Stewart, Matt C
  • Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA.
Schaeffer, David J
  • Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA.

MeSH Terms

  • Animals
  • Glottis
  • Horses
  • Laryngoplasty / veterinary
  • Larynx
  • Vacuum

Grant Funding

  • Arthrex
  • U.S. Department of Agriculture

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Citations

This article has been cited 2 times.
  1. Tucker ML, Wilson DG, Bergstrom DJ, Carmalt JL. Computational fluid dynamic analysis of upper airway procedures in equine larynges. Front Vet Sci 2023;10:1139398.
    doi: 10.3389/fvets.2023.1139398pubmed: 37138910google scholar: lookup
  2. Gray SM, Gutierrez-Nibeyro SD, Horn GP, McCoy AM, Schaeffer DJ, Stewart M. The effect of repeated freezing and thawing on the suture pull-out strength in equine arytenoid and cricoid cartilages. Vet Surg 2022 Oct;51(7):1106-1110.
    doi: 10.1111/vsu.13855pubmed: 35815735google scholar: lookup
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