Meta-analysis evaluating resting laryngeal endoscopy as a diagnostic tool for recurrent laryngeal neuropathy in the equine athlete.
Abstract: Resting endoscopy has commonly been used as a method to predict laryngeal function at exercise. Objective: To perform a meta-analysis to determine the sensitivity and specificity of resting laryngeal endoscopy to predict clinical recurrent laryngeal neuropathy at exercise. Methods: Meta-analysis. Methods: Manuscripts were included if data were available for both resting and exercising airway function on all or a subset of horses. Normal resting endoscopy was defined as laryngeal grades 1 or 2 on a 4-/7-point scale or 1, 2 or 3 on a 5-point scale and normal dynamic endoscopy as a dynamic laryngeal grade A. Results: Twelve studies including 1827 horses were evaluated. A small proportion of horses with grade 1 or grade 2 laryngeal function at rest, 3.5 and 11.9%, respectively, were identified as having abnormal laryngeal function at exercise. Within the horses with grade 3 laryngeal function at rest, 16% were classified as grade A, 26.4% as grade B and 57.6% as grade C at exercise. Worsening subgrades within resting grade 3 demonstrated an increasing proportion of complete or partial paralysis at exercise. The sensitivity and specificity of resting endoscopy was 74.4 and 95.1%, respectively, and the positive and negative predictive values were 85.6 and 90.5% respectively. Conclusions: Use of two separate grading systems for evaluating resting laryngeal function. Other forms of dynamic airway collapse were not evaluated. Conclusions: Resting endoscopy is sensitive and highly specific for predicting laryngeal function at exercise. Dynamic endoscopy is important to assess multiple causes of airway collapse.
© 2018 EVJ Ltd.
Publication Date: 2018-08-06 PubMed ID: 29956362DOI: 10.1111/evj.12987Google Scholar: Lookup
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- Journal Article
- Meta-Analysis
- Review
- Athletic Horses
- Athletic Performance
- Clinical Findings
- Clinical Pathology
- Clinical Study
- Comparative Study
- Diagnosis
- Diagnostic Technique
- Disease Diagnosis
- Endoscopy
- Equine Diseases
- Equine Health
- Equine Science
- Exercise
- Horses
- Laryngeal Dysfunction
- Meta-Analysis
- Physiology
- Respiratory Health
- Veterinary Medicine
- Veterinary Research
Summary
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The research article presents a meta-analysis of the effectiveness of resting laryngeal endoscopy as a diagnostic tool for recurrent laryngeal neuropathy in horses during exercise. The study found that resting laryngeal endoscopy is a sensitive and highly specific method to predict laryngeal function at exercise.
Objective and Methods
- The objective of this research was to conduct a meta-analysis to assess the sensitivity and specificity of resting laryngeal endoscopy in predicting the clinical recurrent laryngeal neuropathy in equine athletes during exercise.
- The authors included manuscripts in the study where data was available for both resting and exercising airway function in horses, with or without a subset of horses.
Definition and Results
- The authors defined normal resting endoscopy as laryngeal grades 1 or 2 on a 4-/7-point scale or 1, 2 or 3 on a 5-point scale, and normal dynamic endoscopy as a dynamic laryngeal grade A.
- The study evaluated twelve studies that comprise a total of 1827 horses. The results showed that a small proportion of horses with grade 1 (3.5%) or grade 2 (11.9%) laryngeal function at rest were found to have abnormal laryngeal function during exercise.
- Among horses with a grade 3 laryngeal function at rest, 16% were classified as grade A, 26.4% as grade B, and 57.6% as grade C during exercise. The percentage of horses showing complete or partial paralysis at exercise increased as the subgrades within resting grade 3 worsened.
Sensitivity and Specificity
- The sensitivity and specificity of resting endoscopy were found to be 74.4% and 95.1% respectively. The positive and negative predictive values were 85.6% and 90.5% respectively. This suggests that resting laryngeal endoscopy is a highly reliable method for predicting laryngeal function at exercise.
Conclusions
- The study concluded that resting endoscopy is both sensitive and highly specific for predicting laryngeal function at exercise in the equine athletes. However, two separate grading systems were used for evaluating resting laryngeal function, and other forms of dynamic airway collapse were not evaluated.
- The study also underlines the importance of dynamic endoscopy in assessing multiple causes of airway collapse in equine athletes.
Cite This Article
APA
Elliott S, Cheetham J.
(2018).
Meta-analysis evaluating resting laryngeal endoscopy as a diagnostic tool for recurrent laryngeal neuropathy in the equine athlete.
Equine Vet J, 51(2), 167-172.
https://doi.org/10.1111/evj.12987 Publication
Researcher Affiliations
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
- University of Georgia College of Veterinary Medicine, Athens, Georgia, USA.
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
MeSH Terms
- Animals
- Horse Diseases / diagnosis
- Horses
- Laryngeal Nerve Injuries / diagnosis
- Laryngeal Nerve Injuries / veterinary
- Laryngoscopy / veterinary
- Sports
Citations
This article has been cited 3 times.- Lo Feudo CM, Stancari G, Collavo F, Stucchi L, Conturba B, Zucca E, Ferrucci F. Upper and Lower Airways Evaluation and Its Relationship with Dynamic Upper Airway Obstruction in Racehorses.. Animals (Basel) 2022 Jun 17;12(12).
- Gong QL, Wang Q, Yang XY, Li DL, Zhao B, Ge GY, Zong Y, Li JM, Leng X, Shi K, Liu F, Du R. Seroprevalence and Risk Factors of the Bluetongue Virus in Cattle in China From 1988 to 2019: A Comprehensive Literature Review and Meta-Analysis.. Front Vet Sci 2020;7:550381.
- Cercone M, Hokanson CM, Olsen E, Ducharme NG, Mitchell LM, Piercy RJ, Cheetham J. Asymmetric recurrent laryngeal nerve conduction velocities and dorsal cricoarytenoid muscle electromyographic characteristics in clinically normal horses.. Sci Rep 2019 Feb 25;9(1):2713.
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