In vitro evaluation of the effect of a prototype dynamic laryngoplasty system on arytenoid abduction.
Authors: Ahern Benjamin J, Lim Yee-Wei, van Eps Andrew, Franklin Samantha
Journal: Veterinary surgery : VS
Summary
Recurrent laryngeal neuropathy (RLN) remains a significant cause of exercise-induced airway obstruction in horses, and whilst traditional laryngoplasty improves resting arytenoid abduction, it cannot dynamically adjust to meet the demands of exercise. Ahern and colleagues evaluated a prototype dynamic laryngoplasty system (DLPS)—essentially a pneumatic device capable of actively pulling the paralysed left arytenoid cartilage—using nine equine larynges mounted in an in vitro model where the right arytenoid was maximally abducted to simulate a unilaterally paralysed larynx. Static laryngoplasty suturing alone achieved a left-to-right quotient (LRQ) of 1.07 with approximately 26 mm of total shortening, but when the DLPS was then activated at varying pressure increments (0, 25, and 50 psi or maximum), it further increased the LRQ from 0.70 to 0.97—equivalent to an additional 18.7 mm of functional arytenoid abduction at maximal system pressure (mean 37.33 psi). The findings suggest that pneumatic activation could provide a clinically meaningful supplementary pull on the paralysed cartilage beyond what static suturing alone permits, potentially allowing the airway to open more effectively during high respiratory demands. Before clinical application can be considered, however, researchers need to establish whether this enhanced arytenoid abduction actually translates to reduced airway resistance during exercise and whether the system proves durable and safe implanted in living horses.
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Practical Takeaways
- •A dynamic system could potentially provide additional arytenoid abduction beyond what fixed laryngoplasty alone achieves, though clinical benefit remains to be proven
- •This is early-stage technology development; results are from dissected larynges and do not yet demonstrate effects on actual airway function or patient outcomes
- •Further research is needed to determine if this system would reduce post-operative stridor or improve exercise tolerance compared to conventional laryngoplasty
Key Findings
- •A prototype dynamic laryngoplasty system (DLPS) increased left-to-right quotient (LRQ) from 0.70 to 0.97 upon activation, equivalent to 18.7 mm of suture shortening
- •Maximum pressure achieved by the DLPS was 37.33 ± 5.96 psi
- •Standard laryngoplasty alone achieved LRQ improvement from 0.59 to 1.07 with 25.89 mm of suture shortening across nine larynges
- •The DLPS system demonstrated consistent ability to increase arytenoid abduction in the in vitro model