Ultrasonography was reliable for the detection of SL pathology based on histology as the gold standard. Adhesions may be a reason for recurrent lameness after surgery.
Management of patients with carcinoma of the larynx should systematically include an appropriate treatment of lymph nodes according to the TNM stage. One of the most controversial points of the treatment in these patients is the management of the clinically negative neck (N(0)). A retrospective study of 295 patients with laryngeal carcinoma and N(0) neck undergoing treatment in our centre between 1983 and 1993 is presented. We observed a significant decrease in the survival of clinically N(0) patients with histologically affected lymph nodes. Lymphadenopathy was more frequently detected in patients with supraglottic tumours (38 per cent) when compared to glottic tumours (16 per cent). In our experience, routine bilateral and unilateral dissection of N(0) necks in all supraglottic tumours and in T3-T4 glottic tumours, respectively, is the most beneficial approach for patients in terms of survival.
Adhesion formation between the SL and adjacent structures was detected by high-field MRI with reasonable accuracy. Muscle and adipose tissue pathology was identified either alone or in association with collagenous tissue pathology.
Summary
Reasons for performing study
It has been suggested that ultrasonography is unreliable for the detection of hindlimb proximal suspensory desmopathy (PSD) based on comparisons between ultrasonographic and magnetic resonance images.
Objectives
To compare ultrasonography with gross and histopathological post mortem examination in horses with PSD diagnosed based on ultrasonography and control horses.
Study design
Retrospective descriptive study.
Methods
Part 1: 19 horses with hindlimb PSD and 10 control horses were humanely destroyed. Twenty control limbs and 37 lame limbs were examined grossly and 40 suspensory ligaments (SLs) were examined histologically and graded blindly. Part 2: 3 horses with recurrent lameness after surgical management of PSD and 4 with PSD were assessed ultrasonographically and by gross post mortem examination.
Results
Part 1: ultrasonographic lesions were graded moderate in 31/38 (81.6%) and severe in 7/38 (18.4%) lame limbs; in 4/37 (10.8%) limbs adhesion formation between the proximal aspect of the SL and the accessory ligament of the deep digital flexor tendon was predicted. Gross post mortem and histological examinations of control limbs revealed no abnormalities. Gross post mortem examination revealed substantial adhesions between the proximal aspect of the SL and adjacent soft tissues in 10/37 (27.0%) lame limbs; in 10/37 (27.0%) limbs there were adhesions between the body of the SL and the mid plantar aspect of the third metatarsal bone, extending distally in 6 (16.2%) limbs. Histology revealed abnormalities (grades 1–3) of the collagenous tissue in 25/36 (69.4%) limbs; muscle was abnormal (grades 1–3) in 35/36 (97.2%) limbs and adipose tissue (grades 1–3) in 16/36 (44.4%) limbs. Part 2: adhesions between the SL and adjacent soft tissues were predicted ultrasonographically and confirmed post mortem.
Conclusions
Ultrasonography was reliable for the detection of SL pathology based on histology as the gold standard. Adhesions may be a reason for recurrent lameness after surgery.
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