In vitro mechanical evaluation of equine laryngeal tie-forward constructs prepared with different suture materials and placement patterns

Santos, Magda Guadalupe dos; Gutierrez‐Nibeyro, Santiago D.; Horn, Gavin P.; Hicke, Joshua D.; Stewart, Margaret M.; Schaeffer, David J.

doi:10.2460/ajvr.76.4.373

Cited by 1 publication

(12 citation statements)

References 17 publications

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“…Signalment data, including age, weight, breed, and sex, were available for horses supplying the larynxes (n = 20) used for biaxial testing. Larynges were frozen at −20 • C until mechanical testing was performed (25,(27)(28)(29)(30)(31)(32) and were thawed at room temperature for 24 h prior to testing. The larynges were wrapped in isotonic saline-soaked gauze after they were thawed to keep them moist until tested.…”

Section: Preparation Of the Larynxesmentioning

confidence: 99%

“…Laryngeal constructs were tested in a single cycle-to-failure test using an electromechanical testing system with a 5-kN maximum load cell 3 . The larynges were mounted to the machine as previously described (25). Briefly, a 3.2-cm diameter cylinder of polyvinyl chloride (PVC) was passed into the lumen of the larynx, and two 3.5 mm diameter, 40 cm long Steinmann pins were placed through the larynx and cylinder perpendicular to the long axis of the cylinder and to each other.…”

Section: Uniaxial Biomechanical Testingmentioning

confidence: 99%

“…of the testing conditions between the specimens. The pullout tests were performed at a distraction rate of 300 mm/min (25). The variables recorded for each construct included maximum load (N), stiffness (N/mm), extension at maximum load (mm), extension at the break (mm), extension at yield (mm), load at yield (N), tensile stress at yield (N/mm 2 ), and tensile stress at maximum load (N/mm 2 ).…”

Section: Uniaxial Biomechanical Testingmentioning

confidence: 99%

“…The LTF procedure is most often performed using polyethylene or polyester sutures (10,11,25,26), and according to previous reports, the procedure can fail if one or both sutures break or tear through the thyroid cartilage. The LTF procedure reported by Woodie et al (11) and Cheetham et al (12) has been modified recently in an attempt to increase the mechanical strength of the construct (5,11,26,27).…”

Section: Introductionmentioning

confidence: 99%

“…Rossignol et al (27) modified the procedure by anchoring the suture to the thyroid cartilage with metallic implants (i.e., "suture buttons"; LTFB), which resulted in improvement of the mechanical stability of the construct during mechanical testing (27). Rossignol et al (27) found, however, that the strength of the modified LTFB construct was inferior to that of the standard LTF construct and reported that the method of failure in both types of constructs was pullout of the suture from the thyroid cartilage (25). An implant that reduces the risk of a pullout from the thyroid cartilage is needed, because the method of failure of the LTF procedure in all tested constructs has been pullout of the construct through the thyroid cartilage.…”

Section: Introductionmentioning

confidence: 99%

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Ex-vivo Mechanical Testing of Novel Laryngeal Clamps Used for Laryngeal Advancement Constructs

et al. 2020

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Rostral laryngeal advancement, also known as laryngeal tie-forward, is used to treat horses for intermittent dorsal displacement of the soft palate and has a morbidity rate of about 6%. We hypothesized that a novel laryngeal clamp would prevent morbidity associated with the sutures tearing through the thyroid cartilage. Larynges (n = 35 horses) were used for ex vivo testing. For uniaxial testing, 15 equine larynges were tested in one of three laryngeal tie-forward constructs [standard laryngeal tie-forward; modified laryngeal tie-forward using a suture-button; and modified laryngeal tie-forward using a laryngeal clamp]. For biaxial testing, 20 larynges were tested in one of two treatment groups: laryngeal tie-forward and laryngeal tie-forward using a laryngeal clamp. Constructs were tested in single cycle-to-failure. Statistical analyses were performed using ANOVA for uniaxial testing and t-tests for biaxial testing. The laryngeal tie-forward using a laryngeal clamp construct was superior to laryngeal tie-forward and laryngeal tie-forward using a suture-button constructs in resistance to pullout in uniaxial testing. The laryngeal tie-forward using a laryngeal clamp presented a significantly different method of failure than the standard laryngeal tie-forward in the biaxial testing. Failure modes for each construct were primarily by suture failure at the clamp (laryngeal tie-forward using a laryngeal clamp), suture pullout through the thyroid cartilage, or, less commonly, tearing of the cricothyroid ligament (laryngeal tie-forward). In uniaxial testing, the laryngeal tie-forward using a laryngeal clamp failed most commonly due to tearing of the cricothyroid ligament, whereas the standard laryngeal tie-forward and the laryngeal tie-forward using a suture-button failed due to the tearing of the cartilage. The laryngeal clamps provided greater stiffness, load at yield, and tensile stress at yield than did the standard construct. Laryngeal clamps may offer an alternative to standard methods of anchoring the thyroid cartilage when performing the laryngeal tie-forward procedure. Further testing and clinical trials are needed to elucidate the utility of the laryngeal tie-forward using a laryngeal clamp.

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