Clinical and Pathological Features in Horses With Advanced Arytenoid Chondritis.
Authors: Bolfa Pompei, Cercone Marta, Dennis Michelle M, Conan Anne, Grevemeyer Bernard, Ducharme Norm G
Journal: Veterinary pathology
Summary
Arytenoid chondritis represents a significant cause of upper airway obstruction in horses, yet optimal surgical management remains unclear because the relationship between clinical presentation and underlying pathology has not been systematically evaluated. Researchers examined 17 horses with naturally occurring advanced arytenoid chondritis and 4 control cartilages post-arytenoidectomy, measuring total cartilage area, quantifying viable tissue, and correlating gross findings with histopathological changes and pre-operative clinical scores. Diseased cartilages were significantly larger than controls (P = .005), with layered lesions combining cavitation, granulation tissue, fibrosis, inflammation, haemorrhage and oedema expanding both medially and laterally; critically, horses amenable to conservative focal medial resection possessed significantly more viable lateral cartilage than those requiring partial arytenoidectomy (P = .02). These findings challenge the traditional approach of wholesale arytenoidectomy by demonstrating that selective medial resection may preserve lateral wall viability in appropriately selected cases, offering a potentially less destructive alternative. For practitioners, this work suggests that detailed pre-operative assessment—including ultrasonographic evaluation of lesion laterality and extent—could guide surgical decision-making, potentially improving long-term functional outcomes by preserving more normal airway geometry and cartilage structure.
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Practical Takeaways
- •Detailed pathological assessment of diseased arytenoid cartilage can guide surgical choice between partial arytenoidectomy and the more conservative focal medial resection approach
- •The medial wall of affected arytenoids is consistently more severely degenerated than the lateral wall—focal medial resection may preserve more functional cartilage structure
- •Clinical scores and ultrasonographic findings should be correlated with gross lesion measurements to optimize surgical decision-making for individual cases
Key Findings
- •Total gross area of affected arytenoid cartilages was significantly larger in chondritis cases than controls (P = 0.005), composed of cavitation, granulation tissue, fibrosis, inflammation, hemorrhage, and edema
- •Cartilage degeneration and necrosis were more severe on the medial aspect while lateral wall cartilage remained more viable in some cases
- •Total gross area correlated positively with surgical management approach required (P = 0.01)
- •Conservative focal medial resection may be suitable for cases with significantly more viable lateral wall cartilage, potentially preserving more arytenoid structure than partial arytenoidectomy