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Frontiers in veterinary science2020; 7; 139; doi: 10.3389/fvets.2020.00139

Ex-vivo Mechanical Testing of Novel Laryngeal Clamps Used for Laryngeal Advancement Constructs.

Abstract: Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forward using a laryngeal clamp]. For biaxial testing, 20 larynges were tested in one of two treatment groups: laryngeal tie-forward and laryngeal tie-forward using a laryngeal clamp. Constructs were tested in single cycle-to-failure. Statistical analyses were performed using ANOVA for uniaxial testing and t-tests for biaxial testing. The laryngeal tie-forward using a laryngeal clamp construct was superior to laryngeal tie-forward and laryngeal tie-forward using a suture-button constructs in resistance to pullout in uniaxial testing. The laryngeal tie-forward using a laryngeal clamp presented a significantly different method of failure than the standard laryngeal tie-forward in the biaxial testing. Failure modes for each construct were primarily by suture failure at the clamp (laryngeal tie-forward using a laryngeal clamp), suture pullout through the thyroid cartilage, or, less commonly, tearing of the cricothyroid ligament (laryngeal tie-forward). In uniaxial testing, the laryngeal tie-forward using a laryngeal clamp failed most commonly due to tearing of the cricothyroid ligament, whereas the standard laryngeal tie-forward and the laryngeal tie-forward using a suture-button failed due to the tearing of the cartilage. The laryngeal clamps provided greater stiffness, load at yield, and tensile stress at yield than did the standard construct. Laryngeal clamps may offer an alternative to standard methods of anchoring the thyroid cartilage when performing the laryngeal tie-forward procedure. Further testing and clinical trials are needed to elucidate the utility of the laryngeal tie-forward using a laryngeal clamp.
Copyright © 2020 Grzeskowiak, Schumacher, Mulon, Steiner, Cassone and Anderson.
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Publication Date: 2020-03-12 PubMed ID: 32226795PubMed Central: PMC7081719DOI: 10.3389/fvets.2020.00139Google 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.

This study tests a novel laryngeal clamp designed to prevent surgical complications in horses undergoing a laryngeal tie-forward procedure. The clamp was found to be superior to standard suturing methods in resisting pullout and was associated with lower rates of failure due to tearing of the thyroid cartilage or cricothyroid ligament.

Study Design and Hypothesis

  • The researchers conducted ex-vivo tests using horse larynges to ascertain the efficacy of a novel laryngeal clamp in preventing morbidity resulting from sutures tearing through the thyroid cartilage in a laryngeal tie-forward surgery. This is a procedure used to treat a horse’s condition marked by the intermittent dorsal displacement of the soft palate.

Test Methodology

  • A total of 35 horse larynges were used in this study. Uniaxial testing was conducted on 15 larynges, which were divided into three groups, each subject to a different laryngeal tie-forward construct – standard, suture-button, and laryngeal clamp.
  • Another 20 larynges were used for biaxial testing, divided into two treatment groups – standard laryngeal tie-forward and laryngeal tie-forward using a laryngeal clamp. The performance of these different constructs was observed in a single cycle-to-failure test.

Results Analysis

  • The data gathered was analysed using statistical tools such as ANOVA for uniaxial testing and t-tests for biaxial testing.
  • Results showed that the laryngeal clamp construct was far more resistant to pullout in uniaxial testing than both the standard and the suture-button constructs.
  • During biaxial testing, the clamp construct failed in a significantly different manner than the standard construct. It was mostly the suture at the clamp that failed, as opposed to the suture pulling out through the thyroid cartilage or tearing of the cricothyroid ligament (as observed in a standard construct).
  • Moreover, the laryngeal clamp displayed greater stiffness, load at yield, and tensile stress at yield when compared to the standard construct. This suggested that laryngeal clamps could provide a more effective alternative to standard suturing methods in anchoring the thyroid cartilage in laryngeal tie-forward surgeries.
  • However, the authors warned that further testing and clinical trials are still needed to ascertain definitively the utility and benefits of using a laryngeal clamp in this procedure.

Cite This Article

APA
Grzeskowiak RM, Schumacher J, Mulon PY, Steiner RC, Cassone L, Anderson DE. (2020). Ex-vivo Mechanical Testing of Novel Laryngeal Clamps Used for Laryngeal Advancement Constructs. Front Vet Sci, 7, 139. https://doi.org/10.3389/fvets.2020.00139

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 7
Pages: 139

Researcher Affiliations

Grzeskowiak, Remigiusz M
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.
Schumacher, James
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.
Mulon, Pierre-Yves
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.
Steiner, Richard C
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.
Cassone, Lynne
  • Veterinary Diagnostic Laboratory, College of Agriculture, Food and Environment, The University of Kentucky, Lexington, KY, United States.
Anderson, David E
  • Department of Large Animal Clinical Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, Knoxville, TN, United States.

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Citations

This article has been cited 3 times.
  1. Lean NE, Sole-Guitart A, Ahern BJ. Laryngeal tie-forward in standing sedated horses. Vet Surg 2023 Feb;52(2):229-237.
    doi: 10.1111/vsu.13920pubmed: 36448601google scholar: lookup
  2. 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.2020.601244pubmed: 33409291google scholar: lookup
  3. Grzeskowiak RM, Freeman LR, Harper DP, Anderson DE, Mulon PY. Effect of cyclic loading on the stability of screws placed in the locking plates used to bridge segmental bone defects. J Orthop Res 2021 Mar;39(3):516-524.
    doi: 10.1002/jor.24838pubmed: 32844515google scholar: lookup
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