Long-term exercising video-endoscopic examination of the upper airway following laryngoplasty surgery: a prospective cross-sectional study of 41 horses.
Authors: Barnett T P, O'Leary J M, Parkin T D H, Dixon P M, Barakzai S Z
Journal: Equine veterinary journal
Summary
# Editorial Summary: Post-Laryngoplasty Upper Airway Assessment Forty-one horses that had undergone laryngoplasty were re-examined using over-ground exercising endoscopy to evaluate surgical success and identify concurrent airway pathology, with resting and exercising videos analysed blindly and correlated against owner-reported outcomes. Despite 93% of owners perceiving the surgery as beneficial, exercising endoscopy revealed upper airway collapse in 78% of cases—41% showing complex, multifactorial collapse patterns—indicating a substantial gap between subjective perception and objective airway function. Poor arytenoid abduction (grades 4–5/5) carried a sixfold increased risk of post-operative respiratory noise compared with good abduction (grades 2–3/5), whilst omission of concurrent ventriculectomy increased this risk 4.9-fold; dynamic palatal dysfunction was particularly prevalent, affecting 56% of horses at exercise versus 24% at rest. For practitioners managing horses with persistent respiratory noise or poor performance post-laryngoplasty, exercising endoscopy should be considered a diagnostic standard rather than an afterthought, as it frequently identifies surgically addressable abnormalities missed by resting examination alone—particularly inadequate arytenoid positioning and dynamic soft palate displacement.
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Practical Takeaways
- •If a horse continues to make respiratory noise after laryngoplasty, perform exercising video-endoscopy to identify concurrent airway problems rather than assuming surgery failure
- •Ensure ventriculectomy is performed concurrently with laryngoplasty to reduce postoperative respiratory noise complications
- •Owner satisfaction with laryngoplasty does not correlate with objective airway function; objective examination is essential for detecting ongoing pathology
Key Findings
- •78% of horses showed some form of upper airway collapse at exercise despite 93% of owners reporting surgery as beneficial
- •Horses with poor arytenoid abduction (grades 4-5/5) were 6 times more likely to make respiratory noise than those with good abduction (grades 2-3/5)
- •Horses without concurrent ventriculectomy were 4.9 times more likely to produce respiratory noise postoperatively
- •Palatal dysfunction prevalence increased from 24% at rest to 56% at exercise, with significant association between resting and exercising diagnosis