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Grzeskowiak R, Schumacher J, Omidi O, Bowers K, Cassone LMC, Abedi R, Hespel AM, Mulon PY, Anderson DE. Enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty using 3-D-printed laryngeal clamps: An ex vivo model study. Vet Surg 2024. [PMID: 38840447 DOI: 10.1111/vsu.14115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/20/2024] [Accepted: 05/05/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To assess a three-dimensional (3-D)-printed laryngeal clamp (LC) designed to enhance the anchoring of laryngeal prostheses at the cricoid cartilage. STUDY DESIGN Ex vivo biomechanical study. SAMPLE POPULATION A total of 22 equine larynges. METHODS Two experimental groups included larynges with standard prosthetic laryngoplasty (PL; n = 10) and larynges with prosthetic laryngoplasty modified with laryngeal clamps (PLLC; n = 10). All constructs underwent 3000 cycles of tension loading and a single tension to failure. Recorded biomechanical parameters included maximum load, actuator displacement, and construct failure. Finite element analysis (FEA) was performed on one PL and one PLLC construct. RESULTS The maximum load at single tension to failure was 183.7 ± 46.8 N for the PL construct and 292.7 ± 82.3 N for the PLLC construct (p = .003). Actuator displacement at 30 N was 1.7 ± 0.5 mm and 2.7 ± 0.7 mm for the PL and PLLC constructs, respectively (p = .011). The cause of PL constructs failure was mostly tearing through the cartilage whereas the PLLC constructs failed through fracture of the cricoid cartilage (p = .000). FEA revealed an 11-fold reduction in the maximum equivalent plastic strain, a four-fold reduction in maximum compressive stress, and a two-fold increase in the volume of engaged cartilage in PLLC constructs. CONCLUSION The PLLC constructs demonstrated superior performance in biomechanical testing and FEA compared to standard PL constructs. CLINICAL SIGNIFICANCE The use of 3-D-printed laryngeal clamps may enhance the outcomes of laryngoplasty in horses. In vivo studies are necessary to determine the feasibility of performing laryngoplasty using the laryngeal clamp in horses.
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Affiliation(s)
- Remigiusz Grzeskowiak
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Jim Schumacher
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Omid Omidi
- Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA
| | - Kristin Bowers
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Lynne M C Cassone
- College of Agriculture, Food and Environment, Veterinary Diagnostic Laboratory, The University of Kentucky, Lexington, Kentucky, USA
| | - Reza Abedi
- Tickle College of Engineering, Mechanical, Aerospace and Biomedical Engineering, The University of Tennessee, Knoxville, Tennessee, USA
| | - Adrien-Maxence Hespel
- College of Veterinary Medicine, Small Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - Pierre-Yves Mulon
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
| | - David E Anderson
- College of Veterinary Medicine, Large Animal Clinical Sciences, The University of Tennessee, Knoxville, Tennessee, USA
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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. [PMID: 36420588 PMCID: PMC10100511 DOI: 10.1111/vsu.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To document variations in the application of equine prosthetic laryngoplasty among equine surgeons. STUDY DESIGN Cross-sectional survey. SAMPLE POPULATION Six hundred and seventy-eight equine surgeons performing prosthetic laryngoplasty. METHODS An online questionnaire was sent to equine surgeons, including diplomates of the American College of Veterinary Surgeons and European College of Veterinary Surgeons. Questions focused on participant profile, surgical technique, antimicrobial therapy, and concurrent procedures. Descriptive statistical analysis was performed on the survey output. RESULTS Complete responses were received from 128/678 individuals, mostly from experienced surgeons. Most participants used 2 prostheses (106/128, 82.8%) and a single loop was the most common method used to anchor the prosthesis in the cricoid (95/128, 74.2%) and arytenoid (125/128, 97.7%) cartilages. Use of general anesthesia was common, although 46/128 (35.9%) participants now performed most laryngoplasty surgery with standing sedation. The material used as a prosthesis varied among surgeons, although participants typically aimed to achieve grade 2 intraoperative arytenoid abduction. Participants most commonly administered perioperative systemic antimicrobial therapy for 1-3 days (57/128, 44.5%) and 48/128 (37.5%) used local antimicrobial therapy. CONCLUSION Most surgeons performed laryngoplasty with 2 prostheses, a single loop construct at the muscular process of the arytenoid cartilage and systemic antimicrobial therapy. There was variation in the preferred method of surgical restraint, prosthesis material selection, and use of local antimicrobial therapy. CLINICAL SIGNIFICANCE Long-established techniques remain popular in clinical practice despite evidence that variations offer advantages, particularly in relation to biomechanics. Other factors are also likely to influence technique selection in a clinical context.
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Gray SM, Gutierrez-Nibeyro SD, Couëtil LL, Horn GP, Kesler RM, McCoy AM, Stewart MC, Schaeffer DJ. Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model. Vet Surg 2021; 50:1409-1417. [PMID: 34309058 DOI: 10.1111/vsu.13690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/10/2021] [Accepted: 07/08/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE 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. STUDY DESIGN Ex-vivo experimental study. SAMPLE POPULATION 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 (cmH2 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 cm2 before and 14.7 ± 2.6 cm2 after cyclic loading, and the mean CSA of the rima glottidis of the standard LP constructs was 16.4 ± 2.9 cm2 before and 15.7 ± 2.8 cm2 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). CONCLUSION The modified toggle and standard LP constructs had comparable airway mechanics in an ex-vivo model. CLINICAL SIGNIFICANCE Further investigation is warranted to determine the extent to which the modified toggle LP technique restores normal airway function in horses with RLN.
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Affiliation(s)
- Sarah M Gray
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Santiago D Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Laurent L Couëtil
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Gavin P Horn
- Illinois Fire Service Institute, University of Illinois, Champaign, Illinois, USA
| | - Richard M Kesler
- Illinois Fire Service Institute, University of Illinois, Champaign, Illinois, USA
| | - Annette M McCoy
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - Matt C Stewart
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
| | - David J Schaeffer
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana-Champaign, Illinois, USA
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Luedke LK, Cheetham J, Mohammed HO, Ducharme NG. Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy. Vet Surg 2020; 49:529-539. [PMID: 32017140 DOI: 10.1111/vsu.13389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 11/13/2019] [Accepted: 01/09/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the efficacy of various treatments for dysphagia after laryngeal surgery. STUDY DESIGN Retrospective. ANIMALS Horses treated for dysphagia after laryngeal surgery. METHODS Medical records of horses treated for dysphagia after prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA) were reviewed. Signalment, prior surgery, preoperative videoendoscopic diagnosis, and surgical treatments were recorded. Short- and long-term follow-up were obtained. Chi-square and logistical regression were performed to correlate independent variables and outcomes. RESULTS Forty-four percent of horses with prior PLP and 88% of horses with prior PA had persistent resting dorsal displacement of the soft palate (DDSP). Vocal fold augmentation (VFA) as a single treatment was most commonly performed (n = 22), followed by laryngoplasty removal (LPR; n = 1). Fifteen horses received a combination of treatments: VFA (n = 15), LPR (n = 4), laryngeal tie-forward (LTF; n = 2), and esophageal release (n = 1). Short-term clinical outcomes were reported; 80% of horses treated with VFA (n = 35) had resolution of dysphagia, and 20% were improved. Among the 33 horses available to long-term follow-up, 31 (94%) returned to some level of work, and DDSP during work was reportedly resolved in 23 of 25 horses. CONCLUSION Vocal fold augmentation resulted in resolution of symptoms relating to dysphagia in 81% of horses. Twenty percent of horses treated with LPR had sustained resolution of dysphagia. A combination of LPR, VFA, LTF was performed in 18% of horses. CLINICAL SIGNIFICANCE Treatment options directed at altering laryngeal geometry and/or position of the larynx were successful in resolving 86% of dysphagia in horses previously regarded as very difficult to treat.
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Affiliation(s)
- Lauren K Luedke
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Jonathan Cheetham
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Hussni O Mohammed
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
| | - Norm G Ducharme
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York
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Miller S, Carstens A. Ultrasonographic findings post laryngoplasty in the horse. Vet Radiol Ultrasound 2019; 60:707-716. [PMID: 31313431 DOI: 10.1111/vru.12788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/26/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022] Open
Abstract
Laryngoplasty is commonly used to treat laryngeal hemiplegia in Thoroughbred racehorses. Evaluation of the success of the laryngoplasty is traditionally determined using endoscopy. Laryngeal ultrasonography and normal ultrasonographic appearance have been reported in the standing horse, but post-laryngoplasty and ventriculectomy ultrasonographic evaluation has limited literature coverage. A prospective case series of 10 Thoroughbred racehorses with left laryngeal hemiplegia was examined ultrasonographically and endoscopically prior to 3-10 days, 30-50 days, and 6-12 months after laryngoplasty and ventriculectomy. Anatomical structures and Plica vocalis movements were described and measurements and gradings analyzed by repeated means analysis of variance (P < .05). Postsurgical ultrasonographic visualization of Ventriculus laryngis entrances was possible. The distance between Plica vocalis in exhalation was significantly larger than that during inhalation (P < .05). Pre- and postsurgical caudal Basihyoideum and rostral Cartilago thyroidea depth was significantly different in some instances (P < .05). No significant differences in the Muscularis cricoarytenoideus lateralis measurements were found. Complications in the extra-luminal structures were found in seven horses including soft tissue swelling, seroma, and hematoma. A luminal Plica vocalis abscess and Plica vocalis granuloma were also detected ultrasonographically. Ultrasonography can be used to evaluate the post-laryngoplasty horse for assessing the success of the procedure, monitoring healing, and detecting complications.
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Affiliation(s)
- Sean Miller
- Section Diagnostic Imaging, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - Ann Carstens
- Section Diagnostic Imaging, Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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Fitzharris LE, Lane JG, Allen KJ. Outcomes of horses treated with removal of a laryngoplasty prosthesis. Vet Surg 2019; 48:465-472. [DOI: 10.1111/vsu.13150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 11/07/2018] [Accepted: 11/29/2018] [Indexed: 11/29/2022]
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Ahern BJ, Lukas E, Lam K, Wilke E, Bertin FR, Van Eps A, Franklin S. Evaluation of a prototype dynamic laryngoplasty system in vitro with an equine vacuum airflow system. Vet Surg 2018; 48:173-179. [PMID: 30569487 DOI: 10.1111/vsu.13137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 04/09/2018] [Accepted: 05/29/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate a prototype dynamic laryngoplasty system (DLPS) in a static airflow model. STUDY DESIGN Experimental. SAMPLE POPULATION Ten equine larynges. METHODS The right arytenoid was fixed in abduction in all specimens. A left-sided laryngoplasty was performed with No. 2 Fiberwire and a FASTakII anchor. Each larynx was tested in a static airflow model. The system was adjusted to a flow rate of 55 L/s and prelaryngeal pressure of 12 mm Hg prior to testing in maximal arytenoid abduction. In phase 1, the left suture was loosened, shortened, and tested in 3-mm steps from 0 to 30 mm. In phase 2, the suture was tied with the DLPS in position at a target left-to-right quotient angle (LRQ) of 0.5. The DLPS was activated to target psi of 0, 25, and 50 for testing. Translaryngeal impedance (TLI), LRQ, cross-sectional areas (CSA), and resultant change in LRQ and CSA between, before, and during airflow testing were calculated. RESULTS In phase 1, TLI was reduced by suture shortening up to 6 mm (P = .001) but not by additional shortening (P > .05). In phase 2, activation of the DLPS reduced the TLI from 0 psi (0.43 ± 0.08 mm Hg/L/s) to 25 psi (0.16 ± 0.04 mm Hg/L/s, P < .001), but no further reduction was detected at maximal psi (P = .10). CONCLUSION Activation of the DLPS effectively reduced TLI. CLINICAL SIGNIFICANCE These results justify further investigation of the DLPS to assess its clinical applicability.
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Affiliation(s)
- Benjamin J Ahern
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Emily Lukas
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Kimberly Lam
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Emma Wilke
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Francois-Rene Bertin
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Andrew Van Eps
- Equine Specialist Hospital, School of Veterinary Science, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Samantha Franklin
- Equine Health and Performance Centre, University of Adelaide, Roseworthy, South Australia, Australia
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Brandenberger O, Martens A, Robert C, Wiemer P, Pamela H, Vlaminck L, Barankova K, Haspeslagh M, Perkins JD, Ducharme N, Rossignol F. Anatomy of the vestibulum esophagi and surgical implications during prosthetic laryngoplasty in horses. Vet Surg 2018; 47:942-950. [DOI: 10.1111/vsu.12944] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Olivier Brandenberger
- Equine Clinic of Grosbois; Boissy St Leger France
- Hanseklinikfür Pferde; Sittensen Germany
| | - Ann Martens
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Céline Robert
- Université Paris-Est, Ecole Vétérinaire d'Alfort; Departement Anatomie; Maisons-Alfort France
| | - Peter Wiemer
- De Lingehoeve Diergeneeskunde; Lienden The Netherlands
| | - Hugo Pamela
- Equine Clinic of Grosbois; Boissy St Leger France
| | - Lieven Vlaminck
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | | | - Maarten Haspeslagh
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - Justin D. Perkins
- Department of Veterinary Clinical Sciences; Royal Veterinary College; North Mymms United Kingdom
| | - Norm Ducharme
- Department of Clinical Sciences, College of Veterinary Medicine; Cornell University; Ithaca New York
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Ahern BJ, Lim YW, van Eps A, Franklin S. In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction. Vet Surg 2018; 47:837-842. [PMID: 30084499 DOI: 10.1111/vsu.12933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 05/11/2018] [Accepted: 05/30/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To determine the effect of a prototype dynamic laryngoplasty system (DLPS) on arytenoid abduction. STUDY DESIGN In vitro experimental. STUDY POPULATION Ten equine larynges. METHODS Dissected larynges were mounted, and the right arytenoid was maximally abducted for testing. A left-sided laryngoplasty (LP) was performed by using a strand of No. 2 FiberWire and a FASTakII anchor. Phase 1 involved tightening the suture, without the DLPS device in place, in 1-mm increments and acquiring a digital image of the rima glottidis at each increment. Phase 2 involved tying the suture with the DLPS in place at a left to right quotient (LRQ) of 0.7. Digital images were subsequently taken at 3 stages of DLPS activation (0, 25, and 50 or maximal psi) and analysed to calculate LRQ. RESULTS All tests were completed for 9 larynges. In phase 1, a total shortening of 25.89 ± 1.27 mm was possible, which increased the LRQ from 0.59 ± 0.02 to 1.07 ± 0.12. In phase 2, activation of the DLPS increased the LRQ from 0.70 ± 0.05 to 0.97 ± 0.09. This change in LRQ equated to 18.7 mm of shortening on the basis of phase 1 results. The maximum psi of the DLPS achieved was 37.33 ± 5.96. CONCLUSION The DLPS increased the degree of arytenoid abduction in vitro. This change in LRQ equated to 18.7 mm of shortening of the LP suture based on phase 1 results. CLINICAL IMPACT These results support further evaluation of the DLPS to determine the effect of changes in DLPS on airway resistance.
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Affiliation(s)
- Benjamin J Ahern
- Equine Specialist Hospital, University of Queensland, Gatton Campus, Gatton, Queensland, Australia
| | - Yee-Wei Lim
- Equine Specialist Hospital, University of Queensland, Gatton Campus, Gatton, Queensland, Australia
| | - Andrew van Eps
- Equine Specialist Hospital, University of Queensland, Gatton Campus, Gatton, Queensland, Australia
| | - Samantha Franklin
- Equine Health and Performance Centre, University of Adelaide, Roseworthy, South Australia, Australia
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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. [DOI: 10.2460/ajvr.79.2.226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Vidovic A, Delling U. Aryepiglottic fold augmentation as treatment for late-onset dysphagia following surgical treatment of recurrent laryngeal neuropathy. Tierarztl Prax Ausg G Grosstiere Nutztiere 2017; 45:219-225. [PMID: 28745776 DOI: 10.15653/tpg-160712] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 01/19/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Coughing and dysphagia have been described following prosthetic laryngoplasty (LP) with or without ventriculectomy/ventriculocordectomy (VE/VCE) for the treatment of recurrent laryngeal neuropathy. All previous case descriptions include patients with acute onset of clinical signs after surgery that persisted. The authors observed a late-onset of dysphagia and coughing months to years after LP ± VE/VCE. The condition was always associated with an abnormality of the aryepiglottic fold (AEF). Treatment options for those patients are limited. We suggest augmentation of the AEF as treatment for affected horses. The goal of the study was two-fold: Firstly, to describe a new condition of late-onset dysphagia in horses following LP ± VE/VCE associated with an abnormal appearance of the AEF, and secondly, to offer a minimally invasive and successful treatment for those patients. MATERIAL AND METHODS Six horses were presented because of dysphagia and coughing with an onset of months to years after LP ± VE/VCE. Endoscopically, the AEF always appeared thinner and more flaccid to a varying degree. The food path was traceable along the AEF into the trachea using dyed molasses. An initial injection of hyaluronic acid (HA) into the AEF led to immediate improvement of the dysphagia. The procedure was performed in the standing sedated horse. The needle was placed through the cricothyroid ligament and the injection performed under endoscopic guidance. RESULTS All horses tolerated the injection well. Injection of HA was successful only in the short term in all cases and repeated injections were needed for permanent resolution using either cross-linked HA, polyacrylamide hydrogel or platelet rich plasma. CONCLUSION AND CLINICAL RELEVANCE Horses may develop dysphagia and coughing months to years after LP ± VE/VCE as a late-onset complication. The condition seems to be associated with an abnormal appearance and function of the AEF. Successful treatment is possible by augmenting the AEF. However, careful patient selection is mandatory.
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Affiliation(s)
- Aleksandar Vidovic
- Dr. Aleksandar Vidovic, Pferdeklinik St. Georg in Trier, Metternichstraße 9, 54292 Trier, Germany,
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Brandenberger O, Rossignol F, Perkins JD, Lechartier A, Mespoulhès-Rivière C, Vitte A, Rossignol A, Ducharme N, Boening KJ. Ex vivo biomechanical stability of 5 cricoid-suture constructs for equine laryngoplasty. Vet Surg 2017; 46:705-713. [DOI: 10.1111/vsu.12671] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/13/2017] [Indexed: 11/25/2022]
Affiliation(s)
- Olivier Brandenberger
- Clinique Vétérinaire de Grosbois; Boissy St. Leger France
- Hanseklinik für Pferde; Sittensen Germany
| | | | - Justin D. Perkins
- Department of Veterinary Clinical Sciences; Royal Veterinary College; North Mymms United Kingdom
| | | | | | | | | | - Norm Ducharme
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine; Cornell University; Ithaca New York
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Ahern BJ, Van Eps AW, Boston RC, Franklin SH. In vitro comparison of 3 techniques of prosthesis attachment to the muscular process of the equine arytenoid cartilage. Vet Surg 2017; 46:700-704. [PMID: 28462516 DOI: 10.1111/vsu.12659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/17/2017] [Accepted: 02/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the degree and ease of arytenoid abduction achieved with abaxial placement of a FASTak II suture anchor compared to 2 suture patterns with different directions of insertion-caudomedial to craniolateral and medial to lateral. STUDY DESIGN Ex vivo experimental. STUDY POPULATION Cadaveric larynges from 10 Standardbred racehorses. METHODS Each larynx was sequentially instrumented with all 3 arytenoid suture attachment in random order: (1) abaxial placement of a FASTak II suture, (2) caudomedial to craniolateral suture, and (3) medial to lateral suture placement. Each construct was abducted at 5N increments from 0 to 25N and the left to right quotient angle ratio (LRQ) measured from digital pictures acquired at each sequential increment. RESULTS Arytenoid abduction (higher LRQ) was greater with FASTak II construct than either of the suture patterns. The largest difference occurred at 5N. Approximately 50% less force was required to achieve an LRQ of 1.0 with the FASTak II anchor compared to the suture patterns. No difference was detected between the 2 suture constructs throughout the study. CONCLUSION Use of the FASTak II suture anchor improved arytenoid abduction compared to 2 suture patterns and minimized the suture loads required to achieve maximum arytenoid abduction. CLINICAL RELEVANCE Use of the FASTak II anchor may decrease the suture load required to achieve arytenoid abduction in clinical cases. This may reduce the load placed on the laryngoplasty, thereby, minimizing postoperative loss of abduction.
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Affiliation(s)
- Benjamin J Ahern
- Equine Specialist Hospital, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Andrew W Van Eps
- Equine Specialist Hospital, University of Queensland, UQ Gatton Campus, Gatton, Queensland, Australia
| | - Raymond C Boston
- University of Pennsylvania, Clinical Studies, New Bolton Center, Kennett Square, Pennsylvania
| | - Samantha H Franklin
- Equine Health and Performance Centre, University of Adelaide, Roseworthy, South Australia, Australia
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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. [DOI: 10.1111/eve.12553] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Biasutti
- Research and Clinical Training Unit; University Veterinary Teaching Hospital; The University of Sydney; Camden New South Wales Australia
| | - A. J. Dart
- Research and Clinical Training Unit; University Veterinary Teaching Hospital; The University of Sydney; Camden New South Wales Australia
| | - L. B. Jeffcott
- Research and Clinical Training Unit; University Veterinary Teaching Hospital; The University of Sydney; Camden New South Wales Australia
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