Histological evaluation of the equine larynx after unilateral laser‐assisted ventriculocordectomy

Robinson, Paul D.; Williams, Kurt J.; Sullins, K. E.; Arnoczky, Steven P.; Stick, John A.; Robinson, N. E.; Feijter-Rupp, Heather De; Derksen, F. J.

doi:10.2746/042516407x175198

Cited by 7 publications

(6 citation statements)

References 17 publications

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“…Estimating 10 minutes of actual electrosurgical energy applied for complete VC would amount to a total of 9000 J. This approximation, although not exact, would be comparable to previous reports of energy used during diode laser VC (8500 J) …”

Section: Discussionsupporting

confidence: 75%

“…Our findings provide evidence that early fibrosis, in the absence of anti‐inflammatory medication, develops at the surgical site by 14 days postoperatively, as inferred by increased collagen deposition. Robinson et al reported increased collagen deposition and mature fibrosis after diode laser VC, with larynges evaluated at 6 months postsurgery. This is comparable with our results, even though we assessed an earlier stage of wound healing.…”

Section: Discussionmentioning

confidence: 99%

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Adaptation and evaluation of a monopolar electrosurgical triangle‐tip knife for transendoscopic ventriculocordectomy in healthy horses

Suarez-Fuentes¹,

Tatarniuk

Caston

et al. 2019

Veterinary Surgery

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Objective: To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. Study design: In vivo experimental study. Study population: Nine horses donated for medical conditions unrelated to respiratory system. Methods: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. Results: Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. Conclusion: Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. Clinical significance: The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Adaptation and evaluation of a monopolar electrosurgical triangle‐tip knife for transendoscopic ventriculocordectomy in healthy horses

Suarez-Fuentes¹,

Tatarniuk

Caston

et al. 2019

Veterinary Surgery

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“…Obviously, cases that receive the highest doses of laser thermal energy administered to the laryngeal tissues are at highest risk of developing collateral thermal damage. While using a diode laser at 20 watts and administering a mean of 8500 Joules for experimental equine ventriculocordectomy, no damage was grossly or histologically found on the opposite vocal cord . In our report, the total laser energy doses administered to either of the horses in the initial surgeries was unknown.…”

Section: Discussionmentioning

confidence: 63%

“…While using a diode laser at 20 watts and administering a mean of 8500 Joules for experimental equine ventriculocordectomy, no damage was grossly or histologically found on the opposite vocal cord. 23 In our report, the total laser energy doses administered to either of the horses in the initial surgeries was unknown. Ahern and Parente noted that prevention of laser damage during equine laryngeal surgery should be the surgeon's aim, by using the minimum amount of energy to complete the procedure and keeping the tissue under tension during resection.…”

Section: Discussionmentioning

confidence: 85%

Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique

et al. 2016

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ObjectiveTo describe a novel surgical technique for correcting postoperative ventral glottic stenosis (cicatrix or web formation) and the outcome in 2 Thoroughbred racehorses.Study DesignRetrospective case report.AnimalsThoroughbreds diagnosed with ventral glottic stenosis (n=2).MethodsHorses presenting with iatrogenic ventral glottic stenosis and resultant exercise intolerance and abnormal exercise‐related noise were anesthetized and a midline sagittal skin incision was made over the ventral larynx and between the sternohyoideus muscles overlying the cricothyroid notch. The cricothyroid ligament, attached laryngeal cicatrix, and overlying mucosa were sagittally sectioned at the dorsal aspect of the cicatrix on the left side. The laryngeal mucosa, cicatrix, and underlying cricothyroid ligament immediately rostral and caudal to the cicatrix were sectioned in a medial (axial) direction as far as the right side of the cricothyroid notch. After resection of the majority of the attached cicatrix tissue, the residual mucosal flap (attached to the right side of the larynx) was reflected ventrally and sutured to the attachment of the cricothyroid ligament on the right side of the cricothyroid notch, creating an intact mucosal layer on the right side of the ventral larynx.ResultsBoth horses had good intralaryngeal wound healing with minimal redevelopment of ventral glottic stenosis at 5 and 9 months postoperatively and were successfully returned to racing with complete absence of abnormal respiratory noise.ConclusionThe unique laryngeal anatomy of horses, with a cartilage‐free ventral laryngeal area (cricothyroid notch), allowed the use of this novel surgical technique to successfully treat ventral glottic stenosis.

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“…Partial arytenoidectomy using video‐assisted diode laser ablation appears to result in minimal tissue trauma in human patients 11–15 . Observation of laryngeal structures can sometimes be impaired, especially in the latter part of the surgery, because the vaporized mucosa and cartilage tend to become dark, making it difficult to recognize the limits of the cricoid cartilage; however, these darkened portions of the vaporized cartilage have been shown to have a preserved histologic cellular organization in man and horses 16,17 …”

Section: Discussionmentioning

confidence: 99%

Video‐Assisted Left Partial Arytenoidectomy by Diode Laser Photoablation for Treatment of Canine Laryngeal Paralysis

Olivieri¹,

Voghera²,

Fossum³

2009

Veterinary Surgery

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Histological evaluation of the equine larynx after unilateral laser‐assisted ventriculocordectomy

Abstract: Laryngeal chondritis is an unlikely consequence of LVC.

Cited by 7 publications

References 17 publications

Adaptation and evaluation of a monopolar electrosurgical triangle‐tip knife for transendoscopic ventriculocordectomy in healthy horses

Adaptation and evaluation of a monopolar electrosurgical triangle‐tip knife for transendoscopic ventriculocordectomy in healthy horses

Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique

Video‐Assisted Left Partial Arytenoidectomy by Diode Laser Photoablation for Treatment of Canine Laryngeal Paralysis

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