Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model

Gray, Sarah M.; Gutierrez‐Nibeyro, Santiago D.; Couëtil, Laurent L.; Horn, Gavin P.; Kesler, Richard M.; McCoy, Annette M.; Stewart, Matt C.; Schaeffer, David J.

doi:10.1111/vsu.13690

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…The repeated freezing and thawing protocol was as follows: following monotonic loading to construct failure on the hemilarynx in the single freeze and thaw group, specimens were placed in a Styrofoam container with ice for 6 h, moved to a −20 °C freezer for 24 h, thawed at 20 °C for 12 h, placed in a Styrofoam container with ice for 8 h, moved to a −20 °C freezer for 24 h, and thawed at 20 °C for 12 h. The remaining hemilarynges then underwent monotonic loading to construct failure (Figure S1 in the supplementary material). This protocol was specifically chosen to mimic the experimental design for another study 28 …”

Section: Methodsmentioning

confidence: 99%

The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

et al. 2022

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Objective To assess the effect of repeated freezing and thawing on the suture pull‐out strength in arytenoid and cricoid cartilages subjected to the laryngoplasty (LP) procedure. Study design Ex vivo experimental study. Sample population Ten grossly normal equine cadaveric larynges. Methods Bilateral LP constructs were created using a standard LP technique. One hemilarynx was randomly allocated to the single freeze and thaw group and the other allocated to the repeated freeze and thaw (3 complete cycles) group. The suture ends of each LP construct were attached to a load frame and subjected to monotonic loading until construct failure. Mean load (N) and displacement (mm) at LP construct failure were compared between groups. Results All LP constructs failed by suture pull through the arytenoid cartilage. The mean load at failure was similar between groups (118.9 ± 25.5 N in the single freeze and thaw group and 113.4 ± 20.5 N in the repeated freeze and thaw group, P = .62). The mean displacement at failure was similar between groups (54.4 ± 15.1 mm in the single freeze and thaw group and 54.4 ± 15.4 mm in the repeated freeze and thaw group, P = .99). Conclusion Repeated freezing and thawing did not affect the suture pullout strength of the arytenoid and cricoid cartilages. Clinical significance Laryngeal specimens that have been subjected to repeated freezing and thawing can be utilized in the experimental evaluation of LP procedures because there is no alteration of the suture pull‐out strength of the relevant cartilages.

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Section: Methodsmentioning

confidence: 99%

The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

et al. 2022

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Equine laryngoplasty: Effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage

Maire,

Ducharme,

Rossignol

et al. 2024

Veterinary Surgery

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ObjectiveTo compare the effects of three anchoring techniques in the muscular process and three positions of laryngoplasty suture implantation in the cricoid cartilage on abduction of the arytenoid cartilage and interaction with the cricoarytenoid dorsalis (CAD) muscle compartments.Study designExperimental study.Sample populationTwenty‐two cadaveric equine larynges.MethodsThree implantation techniques were assessed in the left muscular process. They were the use of a titanium corkscrew (CS), a standard caudal passage using a Jamshidi needle (JCa), and a standard cranial passage using a Jamshidi needle (JCr). Each was assessed in combination with three caudal locations in the cricoid cartilage (right, left, and left lateral). Each suture combination was tightened to submaximal abduction (Dixon grade 2). Force on the suture, degree of larynx caudal rotation, and CAD muscle indentation were evaluated.ResultsThe force required for optimal arytenoid cartilage abduction was lower (p < .01) for constructs involving a CS (7.45 ± 4 N). The CS also resulted in lower (p < .01) CAD muscle indentation (2.01 ± 1.25 mm) and less larynx rotation (9 ± 3.87°; adjusted p < .05).ConclusionWhen inserted into the muscular process at the CAD tendon insertion point, the biomechanical properties of the CS reduced the force required for optimal arytenoid cartilage abduction. The CS also minimized interference with the CAD muscle compartments and reduced caudal displacement of the left arytenoid cartilage when it was under suture tension.Clinical significanceThe CS implantation avoided larynx deformation and muscle interaction, offering the possibility to combine a nerve graft and laryngoplasty as a treatment for recurrent laryngeal neuropathy.

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Computational fluid dynamic analysis of upper airway procedures in equine larynges

et al. 2023

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IntroductionComputational fluid dynamics (CFD) has proven useful in the planning of upper airway surgery in humans, where it is used to anticipate the influence of the surgical procedures on post-operative airflow. This technology has only been reported twice in an equine model, with a limited scope of airflow mechanics situations examined. The reported study sought to widen this application to the variety of procedures used to treat equine recurrent laryngeal neuropathy (RLN). The first objective of this study was to generate a CFD model of an ex-vivo box model of ten different equine larynges replicating RLN and four therapeutic surgeries to compare the calculated impedance between these procedures for each larynx. The second objective was to determine the accuracy between a CFD model and measured airflow characteristics in equine larynges. The last objective was to explore the anatomic distribution of changes in pressure, velocity, and turbulent kinetic energy associated with the disease (RLN) and each surgical procedure performed.MethodsTen equine cadaveric larynges underwent inhalation airflow testing in an instrumented box while undergoing a concurrent computed tomographic (CT) exam. The pressure upstream and downstream (outlet) were measured simultaneously. CT image segmentation was performed to generate stereolithography files, which underwent CFD analysis using the experimentally measured outlet pressure. The ranked procedural order and calculated laryngeal impedance were compared to the experimentally obtained values.Results and discussionThe CFD model agreed with the measured results in predicting the procedure resulting in the lowest post-operative impedance in 9/10 larynges. Numerically, the CFD calculated laryngeal impedance was approximately 0.7 times that of the measured calculation. Low pressure and high velocity were observed around regions of tissue protrusion within the lumen of the larynx. RLN, the corniculectomy and partial arytenoidectomy surgical procedures exhibited low pressure troughs and high velocity peaks compared to the laryngoplasty and combined laryngoplasty/corniculectomy procedures. CFD modeling of the equine larynx reliably calculated the lowest impedance of the different surgical procedures. Future development of the CFD technique to this application may improve numerical accuracy and is recommended prior to consideration for use in patients.

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Evaluation of the airway mechanics of modified toggle laryngoplasty constructs using a vacuum chamber airflow model

Cited by 3 publications

References 34 publications

The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

The effect of repeated freezing and thawing on the suture pull‐out strength in equine arytenoid and cricoid cartilages

Equine laryngoplasty: Effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage

Computational fluid dynamic analysis of upper airway procedures in equine larynges

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