Surgical management of recurrent laryngeal neuropathy

Abstract

Summary Recurrent laryngeal neuropathy (RLN, laryngeal hemiplegia, laryngeal paralysis, ‘roaring’) is common in the equine industry with a prevalence ranging from 2.6–11% in light breeds (Raphel 1982; Lane 1987; Morris and Seeherman 1990) up to 38% in draught breeds (Brakenhoff et al. 2006; Perkins et al. 2009). There are a number of different surgical treatments currently available and more being developed. This article aims to discuss factors affecting choice of treatment and then provide an evidence‐based approach to describe surgical approaches, success rates and morbidity. Specific details of surgical methods are not given as they are readily available in surgical textbooks (Stick 2006; McGorum et al. 2007).

Ultrasonographic findings post laryngoplasty in the horse

“…Allowing these to resolve improves the identification of normal structures. These complications are commonly associated with laryngoplasty and ventriculectomy and for this study were graded as mild. Plica vocalis granuloma formation and Plica vocalis abscessation, while recognized, occur less commonly and were graded as moderate complications.…”

“…Ultrasonographic post-laryngoplasty complications were found in seven horses. Four showed either soft tissue swelling or seroma formation ( Figure 11 and one a marked subcutaneous hematoma These complications are commonly associated with laryngoplasty and ventriculectomy 5,6,9,11,16,20 and for this study were graded as mild.…”

“…Plica vocalis granuloma formation and Plica vocalis abscessation, while recognized, occur less commonly 11,14,20 and were graded as moderate complications. No severe complications were detected.…”

“…Additional known complications include dysphagia, incisional swelling, seroma, infection, sinus tract formation, aryepiglottic fold collapse, Plica vocalis collapse, and upper esophageal incompetence . Ventriculocordectomy may additionally result in laryngeal swelling, granuloma formation, and arytenoid chondritis . Equine post‐laryngoplasty ultrasonographic evaluation has limited coverage in the literature.…”

“…5,6,9,[11][12][13][14][15][16][17][18][19] Ventriculocordectomy may additionally result in laryngeal swelling, granuloma formation, and arytenoid chondritis. [20][21][22] Equine post-laryngoplasty ultrasonographic evaluation has limited coverage in the literature. It has mostly been used in horses to identify laryngoplasty prostheses infection 23 and to evaluate extraluminal laryngeal damage.…”