FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Equine veterinary journal2026; doi: 10.1002/evj.70354

Infection and abduction loss predict equine laryngoplasty failure.

Abstract: Prosthetic laryngoplasty (PL) is the most common surgical treatment for recurrent laryngeal neuropathy (RLN) in horses. Post-operative complications may compromise outcomes, and the influence of breed and anaesthetic approach remains unclear. Objective: To evaluate factors associated with surgical outcome at 3 months following PL, focusing on post-operative complications, anaesthetic modality and breed (particularly Iberian baroque breeds). Methods: Multicentre retrospective cohort study. Methods: Medical records from 181 horses across 7 equine hospitals using the same standardised surgical technique were reviewed. Variables including breed, anaesthesia type, ventriculocordectomy (VeC) method and post-operative complications were analysed using χ or Fisher's exact tests and Spearman correlation. Two binomial generalised linear mixed models, with surgeon as a random effect, evaluated pre/intra-operative predictors and post-operative prognostic factors. Level of significance p < 0.05. Surgical success was defined as the absence of respiratory noise and exercise intolerance at 3 months. Results: Surgical success was achieved in 79.1% of cases. Complications occurred in 33.7% of horses and were negatively associated with treatment success (odds ratio [OR] 0.003; 95% confidence interval [CI] 0.000-0.052; p < 0.001). Major loss of arytenoid abduction (18.2%) and surgical site infection (SSI; 6.6%) were the only variables independently associated with reduced odds of treatment success in the post-operative model (OR 0.011; 95% CI 0.001-0.178; p = 0.001 and OR 0.046; 95% CI 0.004-0.559; p = 0.016, respectively). Breed was not associated with surgical outcome. Conclusions: The retrospective multicentre design may introduce selection bias, variability in clinical practice and heterogeneous follow-up. Conclusions: Major loss of arytenoid abduction and SSI were the strongest predictors of failure, highlighting the importance of meticulous technique, preservation of arytenoid abduction and rigorous infection control to optimise outcomes after PL.
© 2026 EVJ Ltd.
Get Full Text
Publication Date: 2026-11-02 PubMed ID: 42971756DOI: 10.1002/evj.70354Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • 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 the factors influencing the success of prosthetic laryngoplasty (PL) surgery in horses with recurrent laryngeal neuropathy (RLN), focusing on post-operative complications, anaesthesia methods, and breed effects.
  • The research identified major loss of arytenoid abduction and surgical site infection as key predictors of surgical failure, while breed and anaesthetic modality showed no significant effect on outcomes.

Background and Objectives

  • Prosthetic Laryngoplasty (PL): The preferred surgical treatment for recurrent laryngeal neuropathy, a condition causing airway obstruction and exercise intolerance in horses.
  • Challenge: Post-operative complications can reduce surgery success, but influence of horse breed and anaesthetic methods on outcomes is unclear.
  • Objective: To assess factors related to surgical success at 3 months after PL, with a focus on post-operative complications, anaesthesia modality, and breed, particularly in Iberian baroque breeds.

Methods

  • Study Design: Multicentre retrospective cohort study analyzing medical records.
  • Sample: 181 horses treated across 7 equine hospitals, all receiving a standardized surgical technique for PL.
  • Data Collected: Breed, anaesthesia type, ventriculocordectomy (VeC) method, post-operative complications, and surgical success evaluated at 3 months.
  • Statistical Analysis: Used χ or Fisher’s exact tests and Spearman correlation to examine variable relationships.
  • Models: Two binomial generalized linear mixed models, accounting for the effect of surgeon as a random variable, analyzed predictors and prognostic factors related to surgery outcomes.
  • Definition of Success: No respiratory noise and no exercise intolerance 3 months post-surgery.

Results

  • Overall Success Rate: 79.1% of horses had successful outcomes at 3 months.
  • Complications: Occurred in 33.7% of horses and were strongly correlated with lower treatment success (Odds Ratio [OR] 0.003; highly significant).
  • Key Predictors of Failure:
    • Major loss of arytenoid abduction (18.2% of cases) — a critical function in airway management — associated with significantly reduced odds of success (OR 0.011; p=0.001).
    • Surgical site infection (SSI) observed in 6.6% of cases also independently linked to failure (OR 0.046; p=0.016).
  • Breed Influence: No significant association found between horse breed (including Iberian baroque) and surgical outcomes.
  • Anaesthesia and VeC Method: These factors did not significantly predict surgical success or failures.

Conclusions and Implications

  • Most Important Factors: Maintaining arytenoid abduction and preventing surgical site infections are paramount for successful prosthetic laryngoplasty.
  • Clinical Significance: Emphasizes meticulous surgical technique and strict infection control protocols.
  • Breed and Anaesthesia: Findings suggest no modification of surgical approach is necessary based on breed or anaesthetic practices.
  • Limitations: Retrospective nature and multicentre design may introduce variability, potential selection bias, and inconsistent follow-up timing.
  • Future Directions: Prospective studies could help validate these findings and further refine perioperative management to reduce complications.

Cite This Article

APA
Lahuerta M, Argüelles D, Rossignol F, Iglesias-García M, Bulnes F, Becerra P, Méndez J, Vázquez FJ, Izquierdo-Moreno J, Carmona JU, Velloso Alvarez A. (2026). Infection and abduction loss predict equine laryngoplasty failure. Equine Vet J. https://doi.org/10.1002/evj.70354

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Lahuerta, M
  • Department of Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Valencia, Spain.
Argüelles, D
  • Department of Equine Veterinary Surgery, UCO Equine Hospital, Córdoba University UCO, Córdoba, Spain.
Rossignol, F
  • Clinique Vétérinaire Équine de Grosbois, Paris, France.
Iglesias-García, M
  • Department of Equine Veterinary Surgery, European University of Madrid, Villaviciosa de Odón, Spain.
Bulnes, F
  • Department of Equine Veterinary Surgery, UCO Equine Hospital, Córdoba University UCO, Córdoba, Spain.
Becerra, P
  • Department of Equine Veterinary Surgery, Universidade do Porto, Porto, Portugal.
Méndez, J
  • Méndez Equine Hospital, Córdoba, Spain.
Vázquez, F J
  • Department of Equine Veterinary Surgery, University of Zaragoza, Zaragoza, Spain.
Izquierdo-Moreno, J
  • Department of Equine Veterinary Surgery, Complutense University of Madrid, Madrid, Spain.
Carmona, J U
  • Department of Animal Health, University of Caldas, Manizales, Colombia.
Velloso Alvarez, A
  • Department of Animal Medicine and Surgery, Universidad CEU-Cardenal Herrera, CEU Universities, Valencia, Spain.

References

This article includes 38 references
  1. Lane JG, Bladon B, Little DR, Little DRM, Naylor JRJ, Franklin SH. Dynamic obstructions of the equine upper respiratory tract. Part 2: comparison of endoscopic findings at rest and during high‐speed treadmill exercise of 600 Thoroughbred racehorses.. Equine Vet J 2006;38:401–407.
  2. Robinson NE. Consensus statements on equine recurrent laryngeal neuropathy: conclusions of the Havemeyer Workshop.. Equine Vet Educ 2004;16:333–336.
  3. 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;35:579–583.
  4. Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Pickles K. Laryngeal paralysis: a study of 375 cases in a mixed‐breed population of horses.. Equine Vet J 2001;33:452–458.
  5. Derksen FJ, Stick JA, Scott EA, Robinson ΝE, Slocombe RF. Effect of laryngeal hemiplegia and laryngoplasty on airway flow mechanics in exercising horses.. Am J Vet Res 1986;47:16–20.
  6. Dixon PM. Arterial blood gas values in horses with laryngeal paralysis.. Equine Vet J 1982;14:246–248.
  7. Goulden B, Anderson L. Equine laryngeal hemiplegia part II: some clinical observations.. N Z Vet J 1981;29:194–198.
  8. Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Dacre K. 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;35:389–396.
  9. Spiers VC, Tulleners EP, Ducharme NG, Hackett RP. Larynx.. Equine surgery 1992;p. 517–536.
  10. Brown JA, Derksen FJ, Stick JA, Hartmann WM, Robinson NE. Ventriculocordectomy reduces respiratory noise in horses with laryngeal hemiplegia.. Equine Vet J 2003;35:570–574.
  11. Baldwin CM, Ireland JL, Barakzai SZ. Unilateral laser ventriculocordectomy results in increased arytenoid stability in horses with severe left sided recurrent laryngeal neuropathy.. Equine Vet J 2024;56:1149–1154.
  12. Fitzharris LE, Lane JG, Allen KJ. Outcomes of horses treated with removal of a laryngoplasty prosthesis.. Vet Surg 2019;48:465–472.
  13. Russell AP, Slone DE. Performance analysis after prosthetic laryngoplasty and bilateral ventriculectomy for laryngeal hemiplegia in horses: 70 cases (1986–1991).. J Am Vet Med Assoc 1994;204:1235–1241.
  14. Froydenlund TJ, Dixon PM. A review of equine laryngoplasty complications.. Equine Vet Educ 2014;26:98–106.
  15. Maire U, Ducharme NG, Rossignol A, Campos Schweitzer A, Rossignol F. Equine laryngoplasty: effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage.. Vet Surg 2024;53:1185–1195.
  16. Rossignol F, Ducharme NG. Complications in larynx surgery. In: Rubio‐Martinez LM, Hendrickson DA, editors. Complications in equine surgery. St Louis, MO: Elsevier; 2021. p. 438–467.
  17. Parente EJ. Fifty years of recurring struggles with recurrent laryngeal neuropathy. Equine Vet J 2018;50:155–158.
  18. Rossignol F, Vitte A, Boening J, Maher M, Lechartier A, Brandenberger O. Laryngoplasty in standing horses. Vet Surg 2015;44:341–347.
  19. 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;79:226–232.
  20. Dart A, Tee E, Brennan M, Dart C, Perkins N, Chapman S. Effect of prosthesis number and position on rima glottidis area in equine laryngeal specimens. Vet Surg 2009;38:452–456.
  21. Ilahi OA, Younas SA, Ho DM, Noble PC. Security of knots tied with ethibond, fiberwire, orthocord, or ultrabraid. Am J Sports Med 2008;36:2407–2414.
  22. Verwilghen DR, Pelosi A, Abbas M, Allerton F, Archer D, Baxter G. Surgical site infection definitions consensus: a first step toward improving prevention in veterinary medicine. Am J Vet Res 2026;87:ajvr.25.03.0099.
  23. Ducharme NG, Rossignol F. Larynx. In: Auer JA, Stick JA, Kümmerle JM, Prange T, editors. Equine surgery. St Louis MO: Elsevier; 2019. p. 734–769.
  24. Dixon PM, McGorum BC, Railton DI, Hawe C, Tremaine WH, Dacre K. Long‐term survey of laryngoplasty and ventriculocordectomy in an older, mixed‐breed population of 200 horses. Part 2: owners' assessment of the value of surgery. Equine Vet J 2003;35:397–401.
  25. Fitzharris LE, Franklin SH, Allen KJ. The prevalence of abnormal breathing patterns during exercise and associations with dynamic upper respiratory tract obstructions. Equine Vet J 2015;47:553–556.
  26. Biasutti S, Dart AJ, Jeffcott LB. A review of recent developments in the clinical application of prosthetic laryngoplasty for recurrent laryngeal neuropathy: indications, complications and outcome. Equine Vet Educ 2016;29:337–345.
  27. Dziubinski N, Mahlmann K, Lubke‐Becker A, Lischer C. Retrospective identification of bacterial isolates from emergency laparotomy surgical site infections in horses. J Equine Vet Sci 2020;87:102927.
  28. Duscher D, Kiesl D, Aitzetmuller MM, Wenny R, Schableger K, Staud CJ. Seasonal impact on surgical‐site infections in body contouring surgery: a retrospective cohort study of 602 patients over a period of 6 years. Plast Reconstr Surg 2018;142:653–660.
  29. Byrne CA, Hotchkiss JW, Barakzai SZ. Variations in the application of equine prosthetic laryngoplasty: a survey of 128 equine surgeons. Vet Surg 2023;52:209–220.
  30. Fulton IC, Stick JA, Derksen FJ. Laryngeal reinnervation in the horse. Vet Clin North Am Equine Pract 2003;19:189–208.
  31. Brandenberger O, Martens A, Robert C, Wiemer P, Pamela H, Vlaminck L. Anatomy of the vestibulum esophagi and surgical implications during prosthetic laryngoplasty in horses.. Vet Surg 2018;47:942–950.
  32. Barakzai SZ, Dixon PM, Hawkes CS, Cox A, Barnett TP. Upper esophageal incompetence in five horses after prosthetic laryngoplasty.. Vet Surg 2015;44:150–155.
  33. Henderson CE, Sullins KE, Brown JA. Transendoscopic, laser‐assisted ventriculocordectomy for treatment of left laryngeal hemiplegia in horses: 22 cases (1999–2005).. J Am Vet Med Assoc 2007;231:1868–1872.
  34. Orsini JA. Chronicle of laser usage in equine surgery.. J Equine Vet Sci 2002;22:240–245.
  35. Hawkins JF. Complications of endoscopic laser surgery.. In: Rubio‐Martinez LM, Hendrickson DA, editors. Complications in equine surgery. St Louis, MO: Elsevier; 2021. p. 404–412.
  36. Cramp P, Derksen FJ, Stick JA, Nickels FA, Brown KE, Robinson P. Effect of ventriculectomy versus ventriculocordectomy on upper airway noise in draught horses with recurrent laryngeal neuropathy.. Equine Vet J 2009;41:729–734.
  37. Rakesh V, Ducharme NG, Cheetham J, Datta AK, Pease AP. Implications of different degrees of arytenoid cartilage abduction on equine upper airway characteristics.. Equine Vet J 2008;40:629–635.
  38. Greenland S, Mansournia MA, Altman DG. Sparse data bias: a problem hiding in plain sight.. BMJ 2016;352:i1981.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 107,210 horse owners like you who receive our email updates on horse health and nutrition.
OmegaPrime+ Extra-Strength Omega-3 Oil - Mad Barn
NEW PRODUCT
OmegaPrime+
Extra-Strength Omega-3 Oil
Shop Now
×