Laryngoplasty in Standing Horses

Abstract

Objective: To describe the clinical experience with standing laryngoplasty in a series of horses mostly non-racing. Study Design: Case series. Animals: Seventy-one client-owned horses. Methods: Medical records (April 2008-February 2014) of horses treated by standing laryngoplasty for abnormal respiratory noise and or poor performance were reviewed. Horses were included if they had a diagnosis of idiopathic right or left recurrent laryngeal neuropathy confirmed by videoendoscopy. All horses underwent a unilateral laryngoplasty with a unilateral or bilateral ventriculectomy or ventriculocordectomy. Follow-up endoscopy was performed in all horses within 24 hours postoperative, in 24 horses at 2 weeks, and in 65 horses at 6 weeks. Late follow-up was obtained from the trainer, owner, or referring veterinarian by telephone. Results: Laryngoplasty was performed under endoscopic guidance with the horses sedated, and the surgical site was desensitized with local anesthetic solution. Laryngoplasty was completed in all horses and was well tolerated. No hyperabduction was observed. Two horses developed incisional swelling that resolved with drainage only. Late follow-up reported satisfactory improvement in respiration in all but 3 horses. Conclusions: Laryngoplasty performed with the horse standing avoids risks associated with general anesthesia and recovery and yields comparable results in nonracing horses, to laryngoplasty performed with the horse anesthetized. This technique reduces cost and allows accurate intraoperative adjustment of the degree of arytenoid abduction.

Modified first or second cervical nerve transplantation technique for the treatment of recurrent laryngeal neuropathy in horses

“…Individual branches were gently dissected and separated from their surrounding subcutaneous tissue using metzenbaum scissors, Debakey and nerve forceps, and a custom made blunt hook instrument was used to lift up nerves (Fig 4). Twenty-four hours after the nerve graft surgery a standing unilateral or bilateral ventriculocordectomy was performed with a transendoscopic diode laser [17]. Dissection was continued ventrally towards the insertion of the nerves in the OH and dorsally where the nerves traversed the lateral aspect of the carotid artery.…”

Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses

“…Arthroscopy in horses is traditionally performed under GA. General anesthesia has been associated with a mortality rate approximating 1% as well as other perianesthetic risks that remain more prevalent in horses than in other species . Standing techniques eliminate those risks and are currently replacing some procedures traditionally performed under GA in horses . To the best of our knowledge, there is no published information regarding the number of horses requiring arthroscopy of the TCj under GA solely for diagnostic purposes, but it is well known that traditional imaging has some diagnostic limitations .…”

“…Recent trends in equine surgery are toward standing procedures to avoid the cost and risks associated with general anesthesia (GA) and thereby include arthroscopic procedures . Standing arthroscopic techniques have been reported in horses for the diagnosis and/or treatment of pathologies in two joints .…”

Anatomy of the vestibulum esophagi and surgical implications during prosthetic laryngoplasty in horses

“…Two sutures were placed by using a straight hollow Jamshidi needle (13G 17‐cm Jamshidi needle; PBN Medicals, Stenløse, Denmark) through which the same suture material as in group 1 was passed with a 1.5‐mm crochet‐style hook (Figure ) . The directions of the 2 suture placements were as follows: Caudal straight needle placement (J1), in which the Jamshidi needle was inserted through the muscular process perpendicular to the rostral spine of the arytenoid approximately 10 mm cranial and 10 mm ventral to the insertion of the CAD tendon Rostral straight needle placement (J2), in which the needle was passed parallel to J1 but approximately 10 mm more rostral, through the rostral spine …”