Laryngeal tie-forward in standing sedated horses.
Authors: Lean Natasha E, Sole-Guitart Albert, Ahern Benjamin J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Laryngeal Tie-Forward in Standing Sedated Horses Intermittent dorsal displacement of the soft palate (iDDSP) remains a performance-limiting upper airway obstruction in horses, traditionally managed under general anaesthesia. Lean and colleagues evaluated whether laryngeal tie-forward (LTF) could be safely and effectively performed in standing sedated horses using endoscopic guidance, recruiting five healthy experimental controls and five clinical cases with confirmed iDDSP. Radiographic analysis demonstrated significant dorsal repositioning of the basihyoid bone (9.6 mm) and thyrohyoid-thyroid articulation (20.4 mm) at 48 hours post-surgery, with dynamic endoscopy revealing resolution of iDDSP in three clinical cases and marked improvement in two others; one horse showed brief collapse during neck flexion that resolved spontaneously with swallowing. The procedure proved well-tolerated without major peri- or postoperative complications, offering practitioners a meaningful alternative that eliminates anaesthetic risk whilst reducing surgical costs—particularly valuable for performance horses where general anaesthesia carries inherent complications and recovery implications.
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Practical Takeaways
- •Laryngeal tie-forward can now be safely performed in standing sedated horses, avoiding the risks and costs associated with general anesthesia for this upper airway obstruction treatment
- •Short-term endoscopic outcomes are promising, with 80% of clinical cases showing resolution or marked improvement of iDDSP within 48 hours
- •This minimally invasive standing approach may improve accessibility and affordability of surgical treatment for iDDSP in working horses
Key Findings
- •Standing laryngeal tie-forward was successfully completed in all 10 horses (5 experimental, 5 clinical cases) without major complications
- •Basihyoid bone and thyrohyoid-thyroid articulation positioned dorsally by 9.6 mm and 20.4 mm respectively at 48 hours post-operatively
- •3/5 clinical cases showed complete resolution of iDDSP and 2/5 showed marked improvement on dynamic endoscopy at 48 hours
- •Standing procedure under sedation and local anesthesia eliminated general anesthesia risks and reduced surgical costs