Laser vocal cordectomy fails to effectively reduce respiratory noise in horses with laryngeal hemiplegia.
Authors: Brown Jennifer A, Derksen Frederik J, Stick John A, Hartmann William M, Robinson N Edward
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Laryngeal hemiplegia remains a significant performance-limiting condition in horses, yet surgical interventions aimed at reducing the characteristic inspiratory noise have shown variable efficacy. This experimental study evaluated whether laser vocal cordectomy—a procedure involving endoscopic removal of the affected vocal cord—could effectively restore normal upper airway function in six Standardbred horses in which left recurrent laryngeal nerve damage was surgically induced. Researchers measured respiratory noise parameters and upper airway pressure resistance during high-speed treadmill exercise before nerve damage, immediately after inducing hemiplegia, and at multiple timepoints up to 120 days following laser cordectomy. Whilst the procedure did modestly reduce upper airway pressure gradient and certain sound frequency components (formant 2) compared to the paralysed state, these improvements remained substantially worse than baseline values, with overall sound level unchanged; notably, the technique proved no more effective than the more conservative bilateral ventriculocordectomy approach already established in clinical practice. Given these disappointing functional outcomes, unilateral laser vocal cordectomy cannot be justified as a treatment option for noise reduction in laryngeal hemiplegia, and practitioners should continue relying on alternative surgical techniques or conservative management strategies when addressing this condition in affected horses.
Read the full abstract on PubMed
Practical Takeaways
- •Do not use laser vocal cordectomy as a treatment for roaring in laryngeal hemiplegia cases, as it fails to reduce respiratory noise despite some pressure reduction
- •Bilateral ventriculocordectomy remains a more effective surgical option if noise reduction is the clinical goal in affected horses
- •Understand that reducing upper airway pressure alone does not translate to clinically meaningful noise reduction in this condition
Key Findings
- •Laser vocal cordectomy failed to reduce sound level or formant 1 and 3 intensity in horses with laryngeal hemiplegia during maximal exercise
- •The procedure reduced upper airway pressure and formant 2 intensity but these remained significantly elevated compared to baseline
- •Unilateral laser cordectomy provided equivalent obstruction relief to bilateral ventriculocordectomy but without noise reduction benefits