Long‐term survey of laryngoplasty and ventriculocordectomy in an older, mixed‐breed population of 200 horses. Part 2: Owners' assessment of the value of surgery

Abstract

Summary Reasons for performing study: There is continuing debate on the clinical benefit of laryngoplasty (LP) in the treatment of equine laryngeal paralysis. In particular, there is little information available on the clinical value of this surgery in older horses, in non‐Thoroughbreds or in sports or pleasure horses; nor on the relationship between the degree of LP abduction achieved and the clinical value of LP. Objectives: To evaluate the owner's assessment of the value of LP(and combined ventriculocordectomy) in an older, mixed breed and mixed workload population of horses and to also assess the relationship between the degree of LP abduction present and the clinical value of this surgery. Methods: A study (1986–1998) of 200 horses of mixed breed and workload, median age 6 years (prospective 136 cases and retrospective 64 cases) undergoing LP and ventriculocordectomy was undertaken. The degree of laryngoplasty abduction achieved and maintained was semi‐quantitatively evaluated using a 5‐grade system. Results: A survey of 198 owners, a median of 19 months after LP surgery, showed that 91% of cases had returned to full work and 3% to reduced work, including 95% of horses with good (Grade 2) laryngoplasty abduction at 6 weeks after surgery, 91% with moderate (Grade 3) abduction, 88% of cases with minsimal (Grade 4) abduction and just 25% of cases with total loss of surgical abduction (Grade 5). Once back in work, 73% of cases were reported to make no abnormal exercise‐related noises (‘noises’) at exercise, with reduced ‘noises’ reported in some of the 21% of horses that still made ‘noises’. In the other 6% of cases, owners were unsure if ‘noises’ were present. The absence or presence of ‘noises’ once back at work correlated significantly with the degree of surgical arytenoid abduction present at 6 weeks after LP. Once back in work, ‘noises’ were less commonly detected in sports and pleasure horses (absent in 76% of cases) than in racehorses (absent in 60%) of cases. Exercise performance following surgery was reported to be markedly increased in 75% of cases, with 10% showing no difference in exercise performance, 3% showing worse performance, and owners unsure of any effect on exercise performance in 13% of cases. Improved work was reported in 70% of sports and pleasure horses and in 67% of racehorses. Overall, 86% of owners believed LP was worthwhile, 7% believed it was not worthwhile and 6% were unsure of its value. Surgery was reported to be of most benefit to sports horses (e.g. reported worthwhile for 100% of show jumpers) and of least benefit to National Hunt (long distance) racehorses where 71% of owners believed it to be worthwhile. Conclusions and potential relevance: Most horse‐owners believe that LP and combined ventriculocordectomy are of clinical value, especially in sports and pleasure horses. Large scale physiological studies on clinical cases, pre‐ and post operatively, are required to examine more critically the value of such surgery.

Retrospective study investigating causes of abnormal respiratory noise in horses following prosthetic laryngoplasty

“…Implant failure (by suture pull-out or prosthesis breakdown) has been reported in a small proportion (5%) of cases during the first week after surgery [21], and progressive loss of abduction may occur over time in many horses [21,[27][28][29][30]. A recent experimental study hypothesised that suboptimal post operative abduction may predispose horses to other forms of collapse due to increases in negative airway pressure, particularly in the regions of the right aryepiglottal fold and both vocal folds [31].…”

When is ventriculocordectomy all that is required?

“…In clinical terms, 59% of horses were reported to have improved exercise performance after unilateral VEC compared to 75% of horses that underwent LP + VEC (Dixon et al . ; Taylor et al . ).…”

“…Other studies have found no effect of preoperative grade on the results of LP surgery (Dixon et al . ; Barakzai et al . ).…”

“…Two papers by the Edinburgh group (Dixon et al . ; Taylor et al . ) described that a slightly higher percentage of horses were reported by owners to make abnormal respiratory noises after VEC (34%) as compared with LP + VEC (27%).…”

İki Tayda Sol Larengeal Hemipleji Olgusu

“…arış performansını olumsuz yönde etkileyen larengeal hemipleji, safkan ırklar başta olmak üzere bir çok yarış atı ırkında tanımlanmaktadır (1)(2)(3)(4).…”