Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017-2019).
Authors: Caspers McKenna K, Bell Chris D, Tatarniuk Dane M
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Transendoscopic Ventriculocordectomy for Laryngeal Hemiplegia Recurrent laryngeal neuropathy remains a significant performance-limiting condition in horses, and whilst prosthetic laryngoplasty (tie-back surgery) is the standard management, adjunctive procedures to address abnormal tissue vibration can improve outcomes. McKenna and colleagues evaluated monopolar electrosurgical ventriculocordectomy—a transendoscopic technique to remove the vocal fold and ventricle tissue—performed alongside tie-back in 24 clinical cases between 2017 and 2019. The procedure was completed successfully in all horses under sedation with only one case of excessive intraoperative bleeding and no postoperative complications recorded. Among the 20 horses presenting with abnormal airway noise preoperatively, 75% experienced complete resolution of stridor post-surgery, whilst 83% of the 18 horses with exercise intolerance showed full functional recovery. These results suggest that monopolar electrosurgical ventriculocordectomy offers a practical, safe alternative to laser-assisted or laryngotomy approaches, delivering comparable clinical outcomes with the advantage of transendoscopic access and reduced tissue trauma. For practitioners managing laryngeal hemiplegia cases that fail to respond adequately to tie-back alone, this technique warrants consideration as an effective adjunctive strategy to maximise return to athletic function.
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Practical Takeaways
- •For horses with recurrent laryngeal neuropathy refractory to prosthetic laryngoplasty alone, adding transendoscopic ventriculocordectomy significantly improves both resting airway noise and exercise tolerance in the majority of cases
- •Monopolar electrosurgery is a safe and effective alternative to laser or open laryngotomy approaches for this procedure, with minimal hemorrhage risk and no documented postoperative complications in this case series
- •This combined surgical approach may enable return to athletic work in horses that would otherwise remain compromised, warranting consideration in your pre-surgical planning for RLN cases
Key Findings
- •75% of horses (15/20) with preoperative airway noise reported complete resolution following transendoscopic ventriculocordectomy with monopolar electrosurgery combined with prosthetic laryngoplasty
- •83% of horses (15/18) with preoperative exercise intolerance showed complete resolution post-surgery
- •Only 1 of 24 horses experienced intraoperative hemorrhage; no postoperative complications were documented
- •Monopolar electrosurgical ventriculocordectomy achieved comparable clinical outcomes to traditional diode laser or laryngotomy-based excision techniques