Complications in Larynx Surgery

Rossignol, Fabrice; Ducharme, Norm G.

doi:10.1002/9781119190332.ch35

Cited by 2 publications

(4 citation statements)

References 54 publications

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“…A suitable surgical approach and level of dissection are important to permit satisfactory placement of the prosthesis. In the current study, a range of dissection techniques to expose the caudal border of the cricoid were reported by surgeons, which may be a manifestation of surgeon preference; increased dissection close to the cartilage at this site reveals large vessels such as the cranial thyroid artery, caudal laryngeal artery and associated veins, which if damaged can cause intraoperative bleeding that can significantly impact visualization 20–22 . Different dissection preferences may also reflect variation between case populations and disparities in dissection requirements between prosthesis constructs.…”

Section: Discussionmentioning

confidence: 77%

“…In the current study, a range of dissection techniques to expose the caudal border of the cricoid were reported by surgeons, which may be a manifestation of surgeon preference; increased dissection close to the cartilage at this site reveals large vessels such as the cranial thyroid artery, caudal laryngeal artery and associated veins, which if damaged can cause intraoperative bleeding that can significantly impact visualization. 20 , 21 , 22 Different dissection preferences may also reflect variation between case populations and disparities in dissection requirements between prosthesis constructs. It is now well recognized that the esophageal diverticulum is an important structure to avoid during prosthesis placement in the muscular process of the arytenoid cartilage.…”

Section: Discussionmentioning

confidence: 99%

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Variations in the application of equine prosthetic laryngoplasty: A survey of 128 equine surgeons

Byrne

Hotchkiss

Barakzai³

2022

Veterinary Surgery

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Objective: To document variations in the application of equine prosthetic laryngoplasty among equine surgeons.Study design: Cross-sectional survey. Sample population: Six hundred and seventy-eight equine surgeons performing prosthetic laryngoplasty. Methods: An online questionnaire was sent to equine surgeons, including diplomates of the American College of Veterinary Surgeons and European College of Veterinary Surgeons. Questions focused on participant profile, surgical technique, antimicrobial therapy, and concurrent procedures. Descriptive statistical analysis was performed on the survey output. Results: Complete responses were received from 128/678 individuals, mostly from experienced surgeons. Most participants used 2 prostheses (106/128, 82.8%) and a single loop was the most common method used to anchor the prosthesis in the cricoid (95/128, 74.2%) and arytenoid (125/128, 97.7%) cartilages. Use of general anesthesia was common, although 46/128 (35.9%) participants now performed most laryngoplasty surgery with standing sedation. The material used as a prosthesis varied among surgeons, although participants typically aimed to achieve grade 2 intraoperative arytenoid abduction. Participants most commonly administered perioperative systemic antimicrobial therapy for 1-3 days (57/128, 44.5%) and 48/128 (37.5%) used local antimicrobial therapy. Conclusion: Most surgeons performed laryngoplasty with 2 prostheses, a single loop construct at the muscular process of the arytenoid cartilage and systemic antimicrobial therapy. There was variation in the preferred method of surgical restraint, prosthesis material selection, and use of local antimicrobial therapy.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Variations in the application of equine prosthetic laryngoplasty: A survey of 128 equine surgeons

Byrne

Hotchkiss

Barakzai³

2022

Veterinary Surgery

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“…This was observed in the horse reported here. Abduction loss is less common in horses after 6 weeks of surgery (Rossignol & Ducharme, 2021). Horses with loss or arytenoid abduction in the post‐operative period may show recurrence of clinical signs; however, in this case, clinical signs did not recur and the horse continued competing without noticeable respiratory noise, and with stable arytenoid cartilage and vocal folds as shown in the repeated exercise endoscopy performed at 6 months post‐operatively.…”

Section: Discussionmentioning

confidence: 99%

“…Under endoscopic guidance, a solution containing 60 ml lidocaine (Alfacaine 2%, Alfasan Nederland BV) and 20 ml mepivacaine (Mepidor, Animalcare Ltd.) was topically applied over the larynx, pharynx and nasal passages. Using a grasping broncho‐oesophageal forceps (Medicon) and diode laser (600 μm bare quartz fibre in contact, and 20 W, 5000 J, Thorlabs) both left and right laryngeal ventricles were everted and excised, a cordectomy was performed on the left and a transverse cut was performed on the abaxial aspect of the right vocal cord as described previously (Rossignol et al, 2015), to decrease risk of complications such as webbing of the remnants of the vocal cords, chronic coughing and/or aspiration pneumonia (Rossignol & Ducharme, 2021). A left‐sided laryngoplasty was then performed as described on the standing horse (Rossignol et al, 2015).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Successful treatment of laryngeal dysplasia with ventriculocordectomy and prosthetic laryngoplasty in a horse

Morelli

Rubio‐Martínez

2023

Equine Veterinary Education

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Summary Prosthetic laryngoplasty is a recognised treatment option for recurrent laryngeal neuropathy (RLN) in horses; however, there is no report of the use of laryngoplasty alone or in combination, as a successful treatment of equine laryngeal dysplasia. A 6‐year‐old Warmblood gelding was referred to the hospital for investigation of respiratory noise and exercise intolerance. Grade 4 recurrent laryngeal neuropathy and bilateral vocal fold collapse were diagnosed with overground endoscopy. Ultrasonography revealed laryngeal dysplasia. The horse underwent standing laser bilateral ventriculectomy, left vocal cordectomy, right vocal cordotomy and left‐sided laryngoplasty. Abnormal structural anatomy of the left aspect of the larynx consistent with laryngeal dysplasia was identified during surgery. Post‐operatively, the horse showed substantial clinical improvement with decreased respiratory noise and improved exercise capacity. Follow‐up overground endoscopy at 6 months post‐operative revealed Dixon grade 4 abduction of the left arytenoid cartilage. Follow‐up information via telephone conversation with the owner confirmed that the horse continued in active exercise with clinical improvement. This case report highlights the value of combined clinical, endoscopic and ultrasonographic examinations of the larynx in a horse with laryngeal dysplasia and concurrent grade 4 RLN and the successful surgical treatment achieved with combined bilateral ventriculectomy, left vocal cordectomy, right vocal cordotomy and prosthetic laryngoplasty.

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Complications in Larynx Surgery

Cited by 2 publications

References 54 publications

Variations in the application of equine prosthetic laryngoplasty: A survey of 128 equine surgeons

Variations in the application of equine prosthetic laryngoplasty: A survey of 128 equine surgeons

Successful treatment of laryngeal dysplasia with ventriculocordectomy and prosthetic laryngoplasty in a horse

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