Biomechanics of Prosthetic Laryngoplasty

Ex Vivo Mechanical Evaluation of a Sternal ZipFix®Implant for Prosthetic Laryngoplasty in Horses

“…Multiple alternative materials have previously been evaluated for use in prosthetic laryngoplasty, including a steel cable and washers, an alternate laryngoplasty system, and a monofilament nylon cranial cruciate ligament repair system; however, these reports have each used a different methodology, making it difficult to compare between studies. We replicated the methodology of previous reports for our study to enable comparisons across studies . Although Kelly et al and Dart et al reported that a double strand of suture has a biomechanical advantage in vivo compared with a single strand, we chose to use a single strand so as to solely compare implant materials in similar formats (single stand).…”

“…An ex vivo model for mechanical evaluation of materials used for prosthetic laryngoplasty in horses has been described . Research using this model has recently focused on evaluating conventional materials for prosthetic laryngoplasty; however, no reports have used this model to look at larger, novel materials that may limit implant pull‐through within the laryngeal cartilages.…”

“…An ex vivo model for mechanical evaluation of materials used for prosthetic laryngoplasty in horses has been described. [21][22][23][24] Research using this model has recently focused on evaluating conventional materials for prosthetic laryngoplasty; however, no reports have used this model to look at larger, novel materials that may limit implant pullthrough within the laryngeal cartilages. The purpose of this study was to compare resistance of arytenoid and cricoid cartilage failure during single load to failure and under cyclic loading followed by single load to failure in laryngoplasties performed with ZipFix or a single strand of 5 polyester suture (TiCron TM ) using this ex vivo model.…”

Anatomy of the vestibulum esophagi and surgical implications during prosthetic laryngoplasty in horses

“…These results provide evidence that the risk of penetrating the adventitia of the vestibulum esophagi increases with the distance between the suture and the insertion of the CAD (rostral placement of the suture). However, previous studies supported the inclusion of the rostral spine (arcuate crest) in the sutures to achieve maximal biomechanical stability . This practice increases the risk of passing through the adventitia or the lumen of the vestibulum esophagi.…”

“…Our (FR and OB) routine technique starts by placing the sutures through the cricoid cartilage; the caudal apex of the muscular process of the arytenoid is then penetrated approximately 10 mm rostral and ventral to the insertion of the cricoarytenoideus dorsalis muscle (CAD). In all cases, a second suture is placed approximately 5‐10 mm rostral to the first one, passing through the rostral spine (arcuate crest) of the arytenoid cartilage. A Dixon abduction grade 2 has been proposed as a good target in thoroughbred racehorses to accommodate their higher ventilatory demands .…”