Enhancing prosthesis stability at the cricoid cartilage in equine laryngoplasty using 3-D-printed laryngeal clamps: An ex vivo model study.
Authors: Grzeskowiak Remigiusz, Schumacher Jim, Omidi Omid, Bowers Kristin, Cassone Lynne M C, Abedi Reza, Hespel Adrien-Maxence, Mulon Pierre-Yves, Anderson David E
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: 3D-Printed Laryngeal Clamps for Equine Laryngoplasty Recurrent laryngeal neuropathy remains a significant cause of upper airway obstruction in horses, and prosthetic laryngoplasty (the most common surgical remedy) can fail when the prosthesis loosens or tears through the cricoid cartilage. Grzeskowiak and colleagues tested whether a custom 3D-printed laryngeal clamp could reinforce the attachment point and improve construct stability using ex vivo biomechanical testing on 20 equine larynges (10 with standard prosthetic laryngoplasty and 10 with the new clamp-augmented technique). Modified constructs with the laryngeal clamp withstood significantly greater loads before failure (292.7 N versus 183.7 N), and critically, the mode of failure changed from prosthesis tearing through cartilage to cartilage fracture itself—suggesting the clamp distributes forces more effectively across a larger tissue volume. Finite element analysis corroborated these findings, showing an 11-fold reduction in plastic strain and four-fold reduction in compressive stress with the clamp in place. Whilst these promising ex vivo results suggest 3D-printed laryngeal clamps could enhance prosthesis longevity and reduce revision surgery rates, in vivo trials in live horses are essential before this technique can be incorporated into clinical practice to confirm surgical feasibility and long-term biocompatibility.
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Practical Takeaways
- •3D-printed laryngeal clamps show promise for improving prosthesis stability in laryngoplasty, potentially reducing recurrent prosthesis failure rates in clinical cases
- •The mechanism shifts failure from cartilage tearing (typical failure mode) to whole-cartilage fracture, suggesting better load distribution and longer functional lifespan
- •In vivo clinical trials are needed before adoption; this technology may become a valuable option for horses with recurrent laryngeal neuropathy that fail standard laryngoplasty
Key Findings
- •3D-printed laryngeal clamps increased maximum load to failure by 59% compared to standard prosthetic laryngoplasty (292.7 N vs 183.7 N, p=0.003)
- •Laryngeal clamps reduced maximum equivalent plastic strain by 11-fold and compressive stress by 4-fold on finite element analysis
- •Standard prosthesis failed by cartilage tearing while clamp-augmented constructs failed by cartilage fracture, indicating load redistribution across larger cartilage volume
- •Clamp constructs showed increased actuator displacement at 30 N loading (2.7 mm vs 1.7 mm, p=0.011), suggesting different mechanical behavior