Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Using a Mucosal Flap Technique.
Authors: Kane-Smyth Justine, Barnett Timothy P, Mark O'Leary John, Dixon Padraic M
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Surgical Treatment of Iatrogenic Ventral Glottic Stenosis Ventral glottic stenosis—the formation of scar tissue webs in the larynx following surgery—represents a serious complication in racehorses, causing exercise intolerance and abnormal respiratory noise that can end athletic careers. Kane-Smyth and colleagues presented a novel mucosal flap technique specifically designed to address this problem, performing laryngotomy with sagittal sectioning of the stenotic tissue followed by reflection and repositioning of viable mucosa to restore a functional laryngeal lumen. Both treated Thoroughbreds demonstrated excellent healing with minimal recurrence of stenosis at 5 and 9 months post-operatively and returned successfully to racing without residual respiratory abnormalities. The technique leverages the unique equine laryngeal anatomy—specifically the cartilage-free cricothyroid notch region—which permits direct access and reconstruction impossible in other species. For equine practitioners managing post-operative laryngeal complications, this approach offers a viable salvage option when conservative management fails, though outcomes based on two cases suggest the need for further validation and longer-term follow-up data.
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Practical Takeaways
- •If a horse develops ventral glottic stenosis after laryngeal surgery, this mucosal flap technique offers a viable surgical option for restoring normal laryngeal function and returning horses to athletic work
- •The technique takes advantage of the horse's unique laryngeal anatomy (cartilage-free cricothyroid notch) to create stable long-term repair with minimal restenosis risk
- •Success in these 2 cases suggests this approach warrants consideration for managing post-operative laryngeal complications, though larger case series would strengthen recommendations
Key Findings
- •A novel mucosal flap technique using the unique cartilage-free ventral laryngeal anatomy (cricothyroid notch) successfully corrected iatrogenic ventral glottic stenosis in 2 Thoroughbreds
- •Both horses showed good intralaryngeal wound healing with minimal redevelopment of stenosis at 5 and 9 months postoperatively
- •Both treated horses were successfully returned to racing with complete absence of abnormal respiratory noise