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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. [PMID: 38689566 DOI: 10.1111/evj.14101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND There is no objective information reporting the effect of unilateral laser ventriculocordectomy (VeC) on arytenoid abduction or stability. OBJECTIVES To evaluate arytenoid stability and abduction in horses with severe recurrent laryngeal neuropathy (RLN) before and after unilateral laser VeC. STUDY DESIGN Prospective cohort. METHODS Eight horses with grade C or D exercising laryngeal function that underwent unilateral laser VeC were included. Exercising endoscopy was performed before and ≥6 weeks after left-sided laser VeC. Arytenoid stability at maximal exercise was calculated by measuring the left-to-right quotient angle ratio (LRQ) of the corniculate processes at the points of maximal arytenoid abduction (expiration) and maximal arytenoid collapse (inspiration). For each horse, means of measurements obtained for four breaths pre- and post-operatively were used for statistical analysis. RESULTS The difference in LRQ between inspiration and expiration was lower post-operatively (median 0.039; interquartile range [IQR] 0.032-0.047) compared with pre-operatively (median 0.158; IQR 0.083-0.249; p = 0.01) confirming the left arytenoid was more stable following unilateral laser VeC. The degree of improvement was significantly greater for grade D horses compared with grade C horses (p = 0.04). The LRQ measured on maximal abduction was also lower post-operatively (median 0.467; IQR 0.444-0.506) compared with pre-operatively (median 0.578; IQR 0.554-0.655; p = 0.02) indicating the left arytenoid was less abducted following surgery. MAIN LIMITATIONS The sample size was small, no racehorses were included and post-operative assessment was conducted at a variable time after surgery. CONCLUSION Unilateral laser VeC in grade C and D RLN-affected horses results in slightly reduced left arytenoid abduction but increased arytenoid stability.
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Affiliation(s)
| | - Joanne L Ireland
- Institute of Veterinary Science, University of Liverpool, Neston, Cheshire, UK
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Lean NE, Bertin FR, Ahern BJ. Influence of unilateral and bilateral vocal cordectomy on airflow across cadaveric equine larynges at different Rakestraw grades of arytenoid abduction. Vet Surg 2022; 51:974-981. [PMID: 35608018 PMCID: PMC9546136 DOI: 10.1111/vsu.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 03/20/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022]
Abstract
Objective To assess the effect of vocal cordectomy on airflow across equine larynges at different Rakestraw grades of arytenoid abduction using a unidirectional airflow model. Study design Ex vivo, repeated measures. Sample population Twenty cadaveric equine larynges. Methods The right arytenoid cartilage was maximally abducted in all larynges. Each larynx was assigned a Rakestraw grade A or B, and the left arytenoid was abducted accordingly. Each larynx was tested under 3 conditions: intact, left vocal cordectomy (LVC), and bilateral vocal cordectomy (BVC). Translaryngeal pressure and airflow were measured, and digital video footage was obtained. Translaryngeal impedance (TLI) was calculated, and the arytenoid left‐to‐right quotient angle (LRQ) and rima glottis cross‐sectional area (CSA) were measured from standardized still images. Results Vocal cordectomy reduced TLI by 14.5% in LVC in comparison with intact larynges at Rakestraw grade B (P = .014). In Rakestraw grade A position, neither unilateral nor bilateral vocal cordectomy had any effect on TLI. Regardless of Rakestraw allocation, both LVC and BVC increased CSA in comparison with intact larynges (P < .005), with BVC larynges experiencing a greater effect than LVC (P < .0001). Conclusion Using a unilateral airflow model, LVC improved TLI in larynges where arytenoid position approximated Rakestraw grade B. However, when the arytenoid position approximated Rakestraw grade A, there was no effect on TLI following LVC or BVC. Clinical significance Surgeons considering a vocal cordectomy should take into account the degree of arytenoid abduction before performing the procedure, as it may not be warranted from a TLI point of view.
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Affiliation(s)
- Natasha E Lean
- School of Veterinary Science, University of Queensland, Gatton, Queensland
| | - Francois R Bertin
- School of Veterinary Science, University of Queensland, Gatton, Queensland
| | - Benjamin J Ahern
- School of Veterinary Science, University of Queensland, Gatton, Queensland
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Caspers MK, Bell CD, Tatarniuk DM. Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017-2019). Front Vet Sci 2021; 8:628410. [PMID: 33732741 PMCID: PMC7957056 DOI: 10.3389/fvets.2021.628410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/25/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy. Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by phone or email for a follow-up questionnaire. Results: Twenty-four horses underwent unilateral EVC, performed transendoscopically under sedated restraint, using monopolar electrosurgical instrumentation successfully. One horse experienced excessive intraoperative hemorrhage. No horses demonstrated postoperative complications. Twenty cases had a history of increased airway noise prior to surgery. In 15 of these cases (15/20, 75%), the airway noise was reported as fully improved post-surgery. Eighteen cases had a history of exercise intolerance prior to surgery. In 15 of these cases (15/18; 83%), the exercise intolerance was reported as resolved. Conclusion: EVC, in conjunction with prosthetic laryngoplasty, can contribute to improvement of RLN symptoms and aid in the effective return to athletic work. Performing transendoscopic ventriculocordectomy with monopolar electrosurgical instrumentation provides comparable clinical outcomes to traditional techniques using a diode laser or direct excision via laryngotomy.
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Affiliation(s)
- McKenna K Caspers
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
| | - Chris D Bell
- Elders Equine Veterinary Services, Winnipeg, MB, Canada
| | - Dane M Tatarniuk
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA, United States
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Suarez-Fuentes DG, Tatarniuk DM, Caston SS, Bell CD, Loinaz RJ, Hostetter JM. Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses. Vet Surg 2019; 48:481-487. [PMID: 30637790 DOI: 10.1111/vsu.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 10/26/2018] [Accepted: 12/10/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. STUDY DESIGN In vivo experimental study. STUDY POPULATION Nine horses donated for medical conditions unrelated to respiratory system. METHODS The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. RESULTS Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. CONCLUSION Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. CLINICAL SIGNIFICANCE The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.
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Affiliation(s)
| | - Dane M Tatarniuk
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa
| | - Stephanie S Caston
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, Iowa
| | - Chris D Bell
- Department of Equine Sports Medicine and Surgery, Elders Equine Veterinary Service, Winnipeg, Manitoba, Canada
| | - Ricardo J Loinaz
- Department of Equine Sports Medicine and Surgery, Camarero Racetrack Equine Clinic, Canovanas, Puerto Rico
| | - Jesse M Hostetter
- Department of Veterinary Pathology, College of Veterinary Medicine, Iowa State University, Ames, Iowa
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Barakzai SZ, Wells J, Parkin TDH, Cramp P. Overground endoscopic findings and respiratory sound analysis in horses with recurrent laryngeal neuropathy after unilateral laser ventriculocordectomy. Equine Vet J 2018; 51:185-191. [DOI: 10.1111/evj.12993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 07/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - J. Wells
- Department of Music University of York Yorkshire UK
| | | | - P. Cramp
- Hambleton Equine Clinic Great Ayton North Yorkshire UK
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Manneveau G, Lecallard J, Thorin C, Pamela H, Tessier C. Comparison of morphological changes and tactile sensitivity of the pharynx and larynx between four standing sedative and analgesic protocols in eight adult healthy horses. Vet Anaesth Analg 2018; 45:477-486. [DOI: 10.1016/j.vaa.2018.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 02/13/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022]
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Rossignol F, Brandenberger O, Perkins JD, Marie JP, Mespoulhès-Rivière C, Ducharme NG. Modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy in horses. Equine Vet J 2018; 50:457-464. [PMID: 29193393 DOI: 10.1111/evj.12788] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 10/29/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND In horses, the only established method for reinnervation of the larynx is the nerve-muscle pedicle implantation, whereas in human medicine, direct nerve implantation is a standard surgical technique for selective laryngeal reinnervation in human patients suffering from bilateral vocal fold paralysis. OBJECTIVES (1) To describe a modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy (RLN) in horses and (2) evaluate the outcomes of reinnervation using direct nerve needle-stimulation of the first cervical nerve and exercising endoscopy before and after surgery. STUDY DESIGN Case series. METHODS Nerve transplantation surgery, in which the first or second cervical nerve is tunnelled through the atrophied left cricoarytenoideus dorsalis muscle, was performed in combination with ipsilateral laser ventriculocordectomy. Ultrasound-guided stimulation of the first cervical nerve at the level of the alar foramen was used to confirm successful reinnervation post-operatively. Exercising endoscopy was performed before and after surgery. The exercising RLN grade of the left arytenoid was blindly determined at the highest stride frequency for each examination. RESULTS Surgery was performed in 17 client-owned animals with RLN. Reinnervation was confirmed by nerve stimulation and subsequent arytenoid abduction observed in 11 out of 12 cases between 4 and 12 months post-operatively. Fourteen horses had exercising endoscopy before and after surgery. Nine horses had an improved exercising RLN grade, four horses had the same exercising grade and one horse had a worse exercising grade after surgery. MAIN LIMITATIONS A sham-operated control group was not included and follow-up beyond 12 months and objective performance data were not obtained. CONCLUSIONS The modified first or second cervical nerve transplantation technique, using tunnelling and direct implantation of the donor nerve into the cricoarytenoideus dorsalis muscle, resulted in reinnervation in 11 out of 12 cases and improved exercising grade in 9 out of 14 horses within 12 months after surgery.
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Affiliation(s)
- F Rossignol
- Equine Clinic of Grosbois, Boissy St Leger, France
| | - O Brandenberger
- Equine Clinic of Grosbois, Boissy St Leger, France.,Hanseklinik für Pferde, Sittensen, Germany
| | - J D Perkins
- Department of Veterinary Clinical Sciences, Royal Veterinary College, North Mymms, UK
| | - J-P Marie
- Department of Otorhinolaryngology, Head & Neck Surgery, and Experimental Surgery Laboratory, UPRES EA 3830, GRHV, IRIB High Normandy, Rouen University Hospital, Rouen, France
| | | | - N G Ducharme
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
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Colbath AC, Valdés-Martínez A, Leise BS, Hackett ES. Evaluation of two methods for topical application of contrast medium to the pharyngeal and laryngeal region of horses. Am J Vet Res 2017; 78:1098-1103. [PMID: 28836843 DOI: 10.2460/ajvr.78.9.1098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the pharyngeal and laryngeal distribution of radiopaque contrast medium administered orally or via nasopharyngeal catheter to standing horses. ANIMALS 5 healthy adult horses. PROCEDURES A crossover study was conducted. Radiopaque contrast medium (12 mL) was administered orally and via nasopharyngeal catheter to each horse. Pharyngeal and laryngeal distribution of contrast medium was determined by examination of radiographs obtained immediately after administration of contrast medium, compared with those obtained before administration. Regional distribution of contrast medium was graded. Endoscopic examination of the nasopharynx, laryngopharynx, and larynx was performed to confirm radiographic results. RESULTS Examination of radiographs obtained after nasopharyngeal administration revealed contrast medium in the nasopharynx (n = 5), oropharynx (2), laryngopharynx (3), and larynx (5) of the 5 horses. Examination of radiographs obtained after oral administration revealed contrast medium in the oropharynx (n = 4) and larynx (1) of the 5 horses. Endoscopic examination confirmed radiographic findings and was found to be sensitive for detection of contrast medium in the laryngopharynx, whereby detection rates were higher for both administration methods. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that medication administered by use of a nasopharyngeal catheter will result in topical distribution within the nasopharynx, including the dorsal surface of the soft palate, and larynx, although distribution should be evaluated in horses with clinical airway disease to confirm these findings. Oral administration did not result in consistently detectable topical laryngeal distribution but could be used for selected conditions (eg, palatitis).
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Rossignol F, Vitte A, Boening J, Maher M, Lechartier A, Brandenberger O, Martin-Flores M, Lang H, Walker W, Ducharme NG. Laryngoplasty in standing horses. Vet Surg 2015; 44:341-7. [PMID: 25864499 DOI: 10.1111/vsu.12307] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the clinical experience with standing laryngoplasty in a series of horses mostly nonracing. STUDY DESIGN Case series. ANIMALS Seventy-one client-owned horses. METHODS Medical records (April 2008-February 2014) of horses treated by standing laryngoplasty for abnormal respiratory noise and or poor performance were reviewed. Horses were included if they had a diagnosis of idiopathic right or left recurrent laryngeal neuropathy confirmed by videoendoscopy. All horses underwent a unilateral laryngoplasty with a unilateral or bilateral ventriculectomy or ventriculocordectomy. Follow-up endoscopy was performed in all horses within 24 hours postoperative, in 24 horses at 2-weeks, and in 65 horses at 6 weeks. Late follow-up was obtained from the trainer, owner, or referring veterinarian by telephone. RESULTS Laryngoplasty was performed under endoscopic guidance with the horses sedated, and the surgical site was desensitized with local anesthetic solution. Laryngoplasty was completed in all horses and was well tolerated. No hyperabduction was observed. Two horses developed incisional swelling that resolved with drainage only. Late follow-up reported satisfactory improvement in respiration in all but 3 horses. CONCLUSIONS Laryngoplasty performed with the horse standing avoids risks associated with general anesthesia and recovery and yields comparable results in nonracing horses, to laryngoplasty performed with the horse anesthetized. This technique reduces cost and allows accurate intraoperative adjustment of the degree of arytenoid abduction.
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Affiliation(s)
- Fabrice Rossignol
- Clinique Equine de Grosbois, Domaine de Grosbois, Boissy Saint Léger, France
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Barakzai SZ. When is ventriculocordectomy all that is required? EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Compostella F, Tremaine WH, Franklin SH. Retrospective study investigating causes of abnormal respiratory noise in horses following prosthetic laryngoplasty. Equine Vet J 2012:27-30. [DOI: 10.1111/j.2042-3306.2012.00612.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Barakzai SZ, Cheetham J. Endoscopic examination of exercising horses: Effects on diagnosis and treatment of upper respiratory tract disorders. Equine Vet J 2012; 44:501-3. [DOI: 10.1111/j.2042-3306.2012.00625.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Perkins JD, Meighan H, Windley Z, Troester S, Piercy R, Schumacher J. In Vitro Effect of Ventriculocordectomy Before Laryngoplasty on Abduction of the Equine Arytenoid Cartilage. Vet Surg 2011; 40:305-10. [DOI: 10.1111/j.1532-950x.2011.00796.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Cramp P, Derksen FJ, Stick JA, Nickels FA, Brown KE, Robinson P, Robinson NE. Effect of ventriculectomy versus ventriculocordectomy on upper airway noise in draught horses with recurrent laryngeal neuropathy. Equine Vet J 2010; 41:729-34. [PMID: 20095218 DOI: 10.2746/042516409x434099] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Little is known about the efficacy of bilateral ventriculectomy (VE) or bilateral ventriculocordectomy (VCE) in draught horses. OBJECTIVES To compare the effect of VE and VCE on upper airway noise in draught horses with recurrent laryngeal neuropathy (RLN) by use of quantitative sound analysis techniques. HYPOTHESIS In competitive draught horses with grade 4 RLN, VE and VCE reduce upper airway noise during exercise, but VCE is more effective. METHODS Thirty competitive hitch or pulling draught horses with grade 4 RLN were evaluated for upper airway sound during exercise. Respiratory rate (RR), inspiratory (Ti) and expiratory time (Te), the ratio between Ti and Te (Ti/Te), inspiratory (Sli) and expiratory sound levels (Sle), the ratio between Sli and Sle (Sli/Sle), and peak sound intensity of the second formant (F2) were calculated. Eleven horses were treated with VE and 19 with VCE. After 90 days of voice and physical rest and 30 days of work, the horses returned for post operative upper airway sound evaluation and resting videoendoscopy. RESULTS VE significantly reduced Ti/Te, Sli, Sli/Sle and the sound intensity of F2. Respiratory rate, Ti, Te and Sle were unaffected by VE. VCE significantly reduced Ti/Te, Ti, Te, Sli, Sli/Sle and the sound intensity of F2, while RR and Sle were unaffected. The reduction in sound intensity of F2 following VCE was significantly greater than following VE. After VE and VCE, 7/11 (64%) and 15/18 (83%) owners, respectively, concluded that the surgery improved upper airway sound in their horses sufficiently for successful competition. CONCLUSIONS VE and VCE significantly reduce upper airway noise and indices of airway obstruction in draught horses with RLN, but VCE is more effective than VE. The procedures have few post operative complications. POTENTIAL RELEVANCE VCE is recommended as the preferred treatment for RLN in draught horses. Further studies are required to evaluate the longevity of the procedure's results.
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Affiliation(s)
- P Cramp
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan 48824-1314, USA
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Dixon PM, Hahn CN, Barakzai SZ. Recurrent laryngeal neuropathy (RLN) research: where are we and to where are we heading? Equine Vet J 2009; 41:324-7. [PMID: 19562891 DOI: 10.2746/042516409x423082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- P M Dixon
- Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Veterinary Centre, Midlothian, Scotland, UK
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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; 231:1868-72. [DOI: 10.2460/javma.231.12.1868] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Robinson P, Williams KJ, Sullins KE, Arnoczky SP, Stick JA, Robinson NE, de Feijter-Rupp H, Derksen FJ. Histological evaluation of the equine larynx after unilateral laser-assisted ventriculocordectomy. Equine Vet J 2007; 39:222-5. [PMID: 17520972 DOI: 10.2746/042516407x175198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY Trans-endoscopic laser surgery, such as unilateral laser-assisted ventriculocordectomy (LVC), has gained popularity in the treatment of RLN because a laryngotomy incision or general anaesthesia are not required. However, removal of the vocal fold and ventricle takes considerable laser energy and could cause collateral tissue damage, including injury to the adjacent laryngeal cartilages. OBJECTIVES To document the histological effects of laser surgery on laryngeal tissues in horses that have undergone LVC for the treatment of laryngeal hemiplegia (LH). METHODS Six horses were used: 4 with experimentally induced LH that had subsequently undergone LVC 6 months prior to euthanasia; and, 2 horses were used as controls. One of the control horses with naturally occurring LH was used to study the effect of neuropathy alone, whereas the other was subjected to euthanasia immediately following LVC to evaluate the acute effect of laser surgery. Using a band saw, each larynx was sectioned transversely at 5 mm intervals and evaluated histologically. RESULTS Acutely, LVC caused thermal damage to adjacent soft tissues but did not affect the histology of the laryngeal cartilages. Six months after LVC, laryngeal cartilages were histologically normal and there was squamous metaplasia of the repaired laryngeal mucosa, resulting in restitution of the mucosal integrity. CONCLUSIONS Using a diode laser in contact fashion at 20 W, LVC can be used to remove the laryngeal vocal fold and ventricle without causing laryngeal cartilage damage. POTENTIAL RELEVANCE Laryngeal chondritis is an unlikely consequence of LVC.
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Affiliation(s)
- P Robinson
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan 48824, USA
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