Outcomes of horses treated with removal of a laryngoplasty prosthesis.

Authors: Fitzharris Laura E, Lane J Geoffrey, Allen Kate J

Journal: Veterinary surgery : VS

DOI: 10.1111/vsu.13150 PubMed: 30609094Log in to save

Summary

# Laryngoplasty Prosthesis Removal: When the Fix Becomes the Problem Laryngoplasty has become a standard surgical intervention for recurrent laryngeal neuropathy, yet complications can arise that necessitate prosthesis removal. Fitzharris and colleagues reviewed surgical records and long-term outcomes in 1,202 horses treated with laryngoplasty by a single surgeon, identifying 58 cases requiring subsequent prosthesis removal. Coughing and dysphagia accounted for 90% of removal indications, with the degree of arytenoid abduction at the time of removal proving irrelevant to clinical outcome. Among the 32 horses with adequate follow-up data, 66% experienced resolution of presenting signs and 75% successfully returned to exercise, despite the overall complication rate of 3.5%. These findings suggest that whilst laryngoplasty carries modest morbidity requiring revision surgery, removing a problematic prosthesis represents a viable salvage option for horses troubled by iatrogenic airway dysfunction or swallowing difficulties, with favourable medium to long-term prospects for athletic return—though practitioners should counsel owners that one-third of affected horses may continue experiencing clinical signs post-removal.

Read the full abstract on PubMed

Practical Takeaways

•If a horse develops persistent coughing or swallowing difficulties after laryngoplasty, prosthesis removal is a viable treatment option with good success rates (66-75%)
•Arytenoid abduction grade does not predict which horses will respond positively to prosthesis removal, so clinical response rather than endoscopic findings should guide management decisions
•Expect about 1 in 30 laryngoplasty cases to require prosthesis removal, so counsel clients appropriately about potential post-operative complications

Key Findings

•3.5% of horses treated with laryngoplasty (42/1202) subsequently required prosthesis removal
•Coughing/dysphagia was the indication for removal in 90% of cases (52/58)
•Clinical signs resolved in 66% of horses (21/32) following prosthesis removal
•75% of horses (24/32) returned to exercise after prosthesis removal

Conditions Studied

laryngeal hemiplegiarecurrent laryngeal neuropathyiatrogenic coughingdysphagiacomplications of laryngoplasty

Related References

Management of postoperative dysphagia after prosthetic laryngoplasty or arytenoidectomy.

Luedke Lauren K, Cheetham Jonathan, Mohammed Hussni O, Ducharme Norm G(2020)Veterinary surgery : VS

Long-term exercising video-endoscopic examination of the upper airway following laryngoplasty surgery: a prospective cross-sectional study of 41 horses.

Barnett T P, O'Leary J M, Parkin T D H, Dixon P M, Barakzai S Z(2013)Equine veterinary journal

Laryngoplasty in standing horses.

Rossignol Fabrice, Vitte Amélie, Boening Josef, Maher Michael, Lechartier Antoine, Brandenberger Olivier, Martin-Flores Manuel, Lang Hayley, Walker Wade, Ducharme Norm G(2015)Veterinary surgery : VS

Long-term survey of laryngoplasty and ventriculocordectomy in an older, mixed-breed population of 200 horses. Part 1: Maintenance of surgical arytenoid abduction and complications of surgery.

Dixon R M, McGorum B C, Railton D I, Hawe C, Tremaine W H, Dacre K, McCann J(2003)Equine veterinary journal

Upper esophageal incompetence in five horses after prosthetic laryngoplasty.

Barakzai Safia Z, Dixon Paddy M, Hawkes Claire S, Cox Alistair, Barnett Timothy P(2015)Veterinary surgery : VS