Partial arytenoidectomy in 14 standing horses (2013–2017)

Gray, Sarah M.; Gutierrez‐Nibeyro, Santiago D.; Secor, Erica J.

doi:10.1111/vsu.13192

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…Higher levels of air mixing and eddy formation are strongly correlated with severity of obstruction ( 29 , 30 ). This provides further evidence that revisional surgery may be worthwhile in cases with postoperative noise and poor performance as has been suggested clinically ( 3 , 32 ). Another consistent feature of the PA was the presence of negative pressure and high velocity inside the left wall of the larynx.…”

Section: Discussionsupporting

confidence: 71%

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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Section: Discussionsupporting

confidence: 71%

Computational fluid dynamic analysis of upper airway procedures in equine larynges

et al. 2023

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“…Airway contamination is one of the most serious complications faced by clinicians. Clinical signs such as dysphagia and dyspnea have been described in horses after partial arytenoidectomy (6,13). Speirs reported that 36% of horses showed dysphagia after partial arytenoidectomy (13); however, horses showing severe dysphagia after partial arytenoidectomy have been reported less frequently in recent studies (1,6,8,10,15).…”

Section: Discussionmentioning

confidence: 99%

“…Clinical signs such as dysphagia and dyspnea have been described in horses after partial arytenoidectomy (6,13). Speirs reported that 36% of horses showed dysphagia after partial arytenoidectomy (13); however, horses showing severe dysphagia after partial arytenoidectomy have been reported less frequently in recent studies (1,6,8,10,15). Recently, Radcliffe, et al (10) reported airway contamination in horses 3 months after partial arytenoidectomy and laryngoplasty; the apparent inflammatory changes in tracheobronchial fluid indicated that both surgeries caused airway contamination.…”

Section: Discussionmentioning

confidence: 99%

“…A previous study showed that among 76 horses that underwent partial arytenoidectomy with mucosal closure, 13 (17%) underwent re-surgery for granulation tissue at the surgical site (9). Likewise, of 14 horses after partial arytenoidectomy without mucosal closure, 3 (21.4%) had granulation tissue at the surgical site (6). Although granulation tissue at the surgical site is presumed to be caused by dehiscence or suture, no exact cause has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…The goal of treatment is to reduce respiratory noise and improve performance by increasing the diameter of the rima glottis, thereby increasing inspiratory flow. Arytenoidectomy can be applied for failed laryngoplasty (5,6,8,11); however, because total arytenoidectomy complications are fatal to patients (13), subtotal arytenoidectomy or partial arytenoidectomy is usually performed. Subtotal arytenoidectomy involves the removal of the arytenoid cartilage, leaving the corniculate process and the muscular process, while partial arytenoidectomy, which has better outcomes, leaves only the muscular process (5,8).…”

Section: Introductionmentioning

confidence: 99%

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Partial Arytenoidectomy in a Horse

Lee

Park

et al. 2022

J Vet Clin

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A 3-year-old Thoroughbred gelding presented with left laryngeal hemiplegia with a history of laryngoplasty (tie-back surgery) failure. Postoperative endoscopy revealed no abduction or no inflammatory changes in the left arytenoid cartilage. The owner opted for the horse to undergo partial arytenoidectomy due to failed laryngoplasty. A tracheostomy tube was intubated through a mid-cervical tracheotomy to secure the airway under general anesthesia, and; laryngotomy was performed to access the arytenoid cartilage in dorsal recumbency. A partial arytenoidectomy was performed with endoscopic assistance through the left nostril, and the left arytenoid cartilage was removed, excluding the muscular process. Antibiotic and anti-inflammatory agents were administered postoperatively, and the incision site was cleaned using normal saline and antibiotic ointment twice daily. On the 12th postoperative day, endoscopy revealed redundant corniculate process mucosa at the surgical site, which was removed using rongeur forceps directly through the previous laryngotomy incision. The horse showed no significant complications during the hospitalization. Two months after surgery, the surgical site reportedly recovered with no evidence of granulation tissue. The horse returned to training and racing 3 and 7 months postoperatively, respectively. This is the first case report of a partial arytenoidectomy in a horse in South Korea. In this case, the horse returned to training after partial arytenoidectomy without significant complications, indicating that partial arytenoidectomy could be beneficial for failed laryngoplasty.

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Partial arytenoidectomy in 21 standing draught horses with recurrent laryngeal neuropathy

Gray,

Gutierrez‐Nibeyro

2024

Equine Veterinary Education

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SummaryObjectiveTo report the use of standing partial arytenoidectomy (PA) in draught horses affected by left‐sided recurrent laryngeal neuropathy (RLN).Study designRetrospective descriptive study.AnimalsTwenty‐one draught horses diagnosed with left‐sided recurrent laryngeal neuropathy (RLN).MethodsMedical records of 21 draught horses subjected to standing PA to treat left‐sided RLN were reviewed. Data recorded included history, signalment, presenting complaint, athletic or intended use, pre‐ and postoperative resting upper respiratory tract endoscopic findings, perioperative medication, surgical details, postoperative exercise recommendations and follow‐up.ResultsTwenty‐one horses (100%) had a history of abnormal respiratory noise and 15 horses (71%) had exercise intolerance. Of the 19 horses with follow‐up, surgery resolved or significantly reduced the abnormal respiratory noise in 17 horses (90%) and resolved exercise intolerance in all 13 horses with a history of exercise intolerance and follow‐up. None of the horses had signs or evidence of coughing at the time of follow‐up.ConclusionStanding left‐sided PA can resolve the clinical signs associated with left‐sided RLN in draught horses.

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Partial arytenoidectomy in 14 standing horses (2013–2017)

Cited by 4 publications

References 25 publications

Computational fluid dynamic analysis of upper airway procedures in equine larynges

Computational fluid dynamic analysis of upper airway procedures in equine larynges

Partial Arytenoidectomy in a Horse

Partial arytenoidectomy in 21 standing draught horses with recurrent laryngeal neuropathy

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