Ex vivo biomechanical stability of 5 cricoid-suture constructs for equine laryngoplasty.
Authors: Brandenberger Olivier, Rossignol Fabrice, Perkins Justin D, Lechartier Antoine, Mespoulhès-Rivière Céline, Vitte Amelie, Rossignol Anthony, Ducharme Norm, Boening Karl Joseph
Journal: Veterinary surgery : VS
Summary
Recurrent laryngeal neuropathy in horses necessitates laryngoplasty to maintain airway patency, yet long-term surgical failures occur due to suture loosening and loss of arytenoid abduction. Researchers tested five different cricoid-suture construct designs using equine cadaver larynges subjected to cyclic loading and failure testing, measuring arytenoid angle reduction, suture migration, and load-to-failure strength. Constructs using 2 mm Fibertape in a U-shaped configuration—particularly when reinforced with a metallic button placed on the caudoventral cricoid—demonstrated substantially lower arytenoid angle reduction and significantly reduced suture migration compared to traditional single-pass Ethibond sutures, though load-to-failure values were marginally lower in the U-shaped designs. The metallic button construct notably improved biomechanical stability under cyclic loading, suggesting it may reduce postoperative loss of function, though the practical trade-offs between increased stability and potential long-term tissue irritation require in vivo validation. Farriers and veterinary surgeons should be aware that conventional single-pass suturing may not optimise long-term arytenoid positioning; button-reinforced U-loop techniques warrant further investigation as a potentially superior approach to improving surgical durability, particularly for horses requiring maximal airway preservation.
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Practical Takeaways
- •Metallic button reinforcement of cricoid sutures may reduce loss of arytenoid abduction and improve long-term stability of laryngoplasty, potentially reducing recurrence of clinical signs.
- •Standard single-pass suture techniques show greater suture migration under cyclic loading; consider reinforcement strategies in cases at high risk of recurrence.
- •These ex vivo findings suggest metallic button constructs warrant in vivo clinical trials, but until then, standard techniques remain the clinical reference.
Key Findings
- •Metallic button (MB) and U-shaped loop constructs showed significantly lower reduction in left-to-right arytenoid angle quotient (LRQ) compared to standard single-pass Ethibond sutures after cyclic loading.
- •Suture migration during cyclic loading was reduced in MB, U-shaped loop, and double-loop constructs compared to standard Ethibond constructs.
- •Metallic button constructs demonstrated superior resistance to pullout forces compared to single-pass Fibertape and U-shaped loop constructs.
- •Double-loop Fibertape constructs showed intermediate performance with reduced suture migration but lower failure load than standard Ethibond.