Laryngeal advancement surgery improves swallowing function in a reversible equine dysphagia model.
Abstract: Pharyngeal dysphagia is a debilitating, sometimes fatal condition in horses, with multiple aetiologies. The pathophysiology is complex and not fully understood. Treatment is largely supportive. Laryngeal advancement surgery may diminish symptoms of dysphagia and improve swallowing in affected horses. Objective: 1) to induce reversible moderate and marked pharyngeal dysphagia by regional anaesthesia of branches of the glossopharyngeal (IX), vagus (X) and hypoglossal (XII) nerves; 2) to characterise the dysphagia produced by each model; and 3) to determine whether laryngeal advancement surgery improves swallowing in these models. Methods: Experimental design using 6 adult horses. Methods: Two dysphagia models were produced by blocking IX, the pharyngeal branch of X and XII unilaterally (moderate model) and only the pharyngeal branch of X bilaterally (marked model) within the guttural pouches. Both models were performed on each horse before and after surgery in order to assess the effectiveness of the surgical procedure as a potential treatment for pharyngeal dysphagia. Dysphagia was scored by partly blinded observers on a scale of 0-12 based on observations of eating (nonblinded), endoscopic examinations and fluoroscopic swallowing (blinded), where 0 = normal swallow and 12 = severe dysphagia with tracheal aspiration. Data were analysed by 3-factor ANOVA, with significance taken as P<0.05. Results: Dysphagia models were reversible, and horses swallowed normally within 3 h of model induction. The marked dysphagia model impaired movement of feed from the base of the tongue to the oesophagus and caused severe airway contamination. The average dysphagia score (mean ± s.d.) for the marked dysphagia model was 10.6 ± 1.1 before surgery and 6.1 ± 4.3 after surgery (P = 0.007). Laryngeal advancement surgery did not significantly improve the dysphagia scores in the moderate model (P = 0.5). Conclusions: Laryngeal advancement surgery may improve swallowing and reduce aspiration in horses affected with diseases that cause pharyngeal dysphagia.
© 2015 EVJ Ltd.
Publication Date: 2015-05-13 PubMed ID: 25683737DOI: 10.1111/evj.12430Google Scholar: Lookup
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- Clinical Trial
- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research paper discusses how laryngeal advancement surgery can help improve the swallowing function in horses suffering from debilitating and sometimes fatal condition, pharyngeal dysphagia. The study aims to understand if this surgical procedure could be an effective treatment method by testing out two dysphagia models on six adult horses.
Study Overview
- The research was conducted to understand and induce a reversible and moderate level of pharyngeal dysphagia in horses. This was done by anesthetizing certain nerve areas (glossopharyngeal, vagus, and hypoglossal)
- Two dysphagia models were created by blocking certain nerve systems in horses. These models were then used to assess potential improvements in swallowing function both before and after the surgery.
- The study used a set scale to monitor the level of dysphagia based on various observations and examinations, such as endoscopic examinations and fluoroscopic swallowing. This allowed the researchers to track changes in the severity of dysphagia before and after the surgery.
Research Findings
- The research study found that the models for dysphagia were reversible, and the horses returned to normal swallowing within approximately 3 hours.
- The more severe dysphagia model significantly impacted the movement of feed from the base of the tongue to the oesophagus and caused severe airway contamination. However, it was noted that this severity decreased after the surgery from 10.6 ± 1.1 to 6.1 ± 4.3.
- On the other hand, the surgery did not significantly improve dysphagia scores in the moderate model, showing that the operation’s effectiveness depends on the dysphagia’s severity.
Conclusions
- Based on the findings, the researchers concluded that laryngeal advancement surgery could help improve swallowing and reduce aspiration issues in horses suffering from diseases that cause pharyngeal dysphagia.
Cite This Article
APA
Virgin JE, Holcombe SJ, Caron JP, Cheetham J, Kurtz KA, Roessner HA, Ducharme NG, Hauptman JG, Nelson NC.
(2015).
Laryngeal advancement surgery improves swallowing function in a reversible equine dysphagia model.
Equine Vet J, 48(3), 362-367.
https://doi.org/10.1111/evj.12430 Publication
Researcher Affiliations
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, USA.
MeSH Terms
- Animals
- Deglutition Disorders / etiology
- Deglutition Disorders / surgery
- Deglutition Disorders / veterinary
- Female
- Horse Diseases / etiology
- Horse Diseases / surgery
- Horses
- Larynx / surgery
- Male
- Nerve Block / veterinary
Citations
This article has been cited 2 times.- Vahabzadeh-Hagh AM, Goel AN, Frederick JW, Berke GS, Long JL. Transplanted human multipotent stromal cells reduce acute tongue fibrosis in rats. Laryngoscope Investig Otolaryngol 2018 Dec;3(6):450-456.
- Whitehead AE, Whitty J, Scott M, Léguillette R. Reversible dysphagia secondary to guttural pouch mycosis in a gelding treated medically with voriconazole and surgically with carotid occlusion and esophagostomy. Can Vet J 2018 Feb;59(2):165-170.
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