Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.
Authors: Luedke Lauren K, Cheetham Jonathan, Mohammed Hussni O, Ducharme Norm G
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Managing Postoperative Dysphagia Following Laryngeal Surgery Dysphagia represents a significant complication after laryngeal surgery in horses, yet treatment options remain poorly characterised in the literature. This retrospective review examined 44 horses that developed swallowing difficulties following prosthetic laryngoplasty (PLP) or partial arytenoidectomy (PA), evaluating which interventions most effectively resolved clinical signs and enabled return to work. Vocal fold augmentation (VFA) proved most successful as a single treatment, with 80% of horses achieving complete resolution of dysphagia and a further 20% showing improvement; among the 33 horses with long-term follow-up data, 94% returned to some level of work, with dorsal displacement of the soft palate resolved during exercise in 23 of 25 cases. The findings are particularly encouraging given that 44–88% of post-laryngeal-surgery dysphagia cases presented with persistent dorsal displacement of the soft palate—a challenging complication historically regarded as difficult to manage—yet multifaceted approaches combining VFA with laryngoplasty removal, laryngeal tie-forward procedures, or oesophageal release achieved overall success rates of 86%. For equine practitioners encountering postoperative swallowing dysfunction, these results suggest that targeted surgical modifications to laryngeal geometry warrant serious consideration before dismissing cases as untreatable, with VFA emerging as a particularly reliable first-line intervention.
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Practical Takeaways
- •Vocal fold augmentation is the most effective single treatment for postoperative dysphagia, with over 80% success rates; consider this as first-line intervention for horses struggling after laryngeal surgery
- •Most horses (94%) can return to work despite dysphagia complications, but treatment selection matters—consider combination approaches if single VFA does not resolve symptoms
- •Arytenoidectomy carries higher risk of persistent DDSP than laryngoplasty; factor this into preoperative counseling and postoperative management planning
Key Findings
- •Vocal fold augmentation (VFA) resolved dysphagia in 81% of horses and improved symptoms in 20%
- •94% of 33 horses available for long-term follow-up returned to some level of work
- •88% of horses with prior partial arytenoidectomy had persistent resting DDSP compared to 44% with prior prosthetic laryngoplasty
- •Combined treatment approaches (VFA, laryngoplasty removal, laryngeal tie-forward) successfully resolved dysphagia in 86% of cases previously considered very difficult to treat